Frontiers in Psychiatry最新文献

Background: The periods of pregnancy are critical for the mental well-being of women. HIV positive pregnant women are especially vulnerable to experiencing depression and anxiety.

Aim: To determine the prevalence and determinant of depression and anxiety among HIV-positive and HIV negative pregnant women in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi, Nigeria.

Materials and methods: Between January 1 and May 30, 2024, 342 HIV-positive pregnant individuals and an equivalent number of HIV-negative prenatal attendees participated in a cross-sectional survey conducted at NAUTH in Nnewi. A structured questionnaire, the Generalized Anxiety Disorder Assessment, and the Patient Health Questionnaire were used to interview the subjects. IBM Statistical Package for Social Science version 26 was used to analyze the data, and a significance level of less than 0.05 was chosen.

Results: The research involved 684 participants, all of whom screened positive for anxiety and depression. The average scores for anxiety in HIV-positive and HIV-negative women were 16.8 ± 3.8 compared to 8.7 ± 2.3; P <0.001, while for depression the scores were 11.1 ± 4.3 versus 3.1 ± 3.3; P < 0.001, respectively. A significant presence of major depressive and anxiety disorders was discovered among HIV-positive women, with moderate and severe depression affecting 47.7% and 21.9%, respectively, while moderate and severe anxiety were observed in 21.3% and 73.6% of the women. The majority of women in the control group exhibited mild mental health disorders. For HIV-positive women, the significant factors influencing depression included being 30 years old or younger, having a gestational age of 30 weeks or less, possessing a lower educational level, being employed, and being married; for anxiety, key factors were being para 0-3, experiencing psychological IPV, and being married. Among HIV-negative women, significant determinants of depression included being 30 years old or younger, having a low educational level, and being married.

Conclusion: The prevalence of mental health disorders in the study group is extremely high. The rate is unacceptably elevated among pregnant women who are HIV-positive. This emphasizes the need to integrate mental health services into standard maternal healthcare for all women, especially those living with HIV.

Introduction: Brain fog describes a heterogenous symptom encompassing cognitive symptoms, mental fatigue and reduced mental clarity, particularly prevalent among individuals with Post COVID - 19 Condition (PCC). This study aimed to translate and validate the Brain Fog Scale (BFS), originally developed in Polish, among a Greek-speaking population and explore whether individuals diagnosed with PCC report significantly more brain fog symptoms, compared to those without PCC.

Methods: The BFS was translated in Greek, using a forward - backward translation process and was administered online. Principal Component Analysis and Confirmatory Factor Analysis were run to assess factor structure.

Results: A total of 602 individuals (76.6% female) completed the BFS, of which 36 had a self-reported diagnosis of PCC. Internal consistency for the entire sample was excellent, α = 0.96. The BFS largely retained its original three factor structure with little variability: (1) impaired cognitive acuity (α = 0.95), (2) inattentiveness (α = 0.92), (3) mental exhaustion (α = 0.84). A Mann-Whitney U test revealed that individuals diagnosed with PCC reported significantly more brain fog symptoms compared to those without PCC, U = 2178.50, p = .011. MANOVA analyses further indicated significantly higher scores in the impaired cognition Factor among individuals with PCC, F(1, 125) = 7.32, p = .008.

Conclusion: The BFS comprises a valid tool for assessment of brain fog and can facilitate person-centred rehabilitation planning in PCC. Findings are discussed in relation to the literature regarding brain fog symptom burden in PCC with suggestions for future research made.

Objective: Children with ADHD are at increased risk for developing gaming addiction, but the psychosocial mechanisms underlying this relationship remain poorly understood. This study aimed to identify factors that mediate this risk.

Method: We analyzed data from three consecutive waves (Years 2-4) of the Adolescent Brain Cognitive Development^SM (ABCD^®) Study, including approximately 7,260 participants. Linear mixed-effects models were used to assess the longitudinal association between ADHD diagnosis (measured via the Kiddie Schedule for Affective Disorders and Schizophrenia [KSADS]) and scores on the Video Game Addiction Questionnaire (VGAQ). A parallel mediation model was then employed to evaluate the role of nine psychosocial factors in mediating this relationship.

Results: Children with ADHD had significantly higher VGAQ scores over time, with an average increase of 1.3 points (p < 0.001) compared to those without ADHD. The mediation model identified three significant psychosocial mediators: prosocial peer involvement (7.4% of the total effect), school involvement (5.8%), and family conflict (5.1%).

Conclusion: Prosocial peer involvement, school engagement, and family conflict emerged as key psychosocial pathways linking ADHD to gaming addiction. These findings have important public health implications and suggest that strengthening peer networks and family environments may be effective targets for intervention in children with ADHD.

Given the research consensus that personality disorder often onsets in adolescence, more work is needed to investigate parent-child discrepancies in reporting on personality disorder, particularly during the pre- and early adolescent period when more significant impairment in personality functioning may be developing or can already be observed. The current study examined concordance of parent- and child-reported level of personality functioning (LPF, as defined in the DSM-5 Alternative Model of Personality Disorders) among pre- and early adolescents and examined the extent to which this concordance was associated with clinically relevant outcomes. Participants included N = 432 children between the ages of 10 and 15 years from three samples oversampled for psychopathology symptoms and their parents. Children and their parents reported on child impairment in personality functioning with the Level of Personality Functioning Scale Brief Form 2.0. Outcomes included parent-reported caregiver strain, parent-reported child functional impairment, and child-reported history of thoughts and behaviors related to suicide and non-suicidal self-injury. Latent profile analysis was conducted to identify profiles of children based on patterns of convergence and divergence between parent- and child-reported LPF. Profile membership was then used to predict outcomes. A four-profile model, with two parent-child convergent and two parent-child divergent profiles, demonstrated the best fit. Convergence on high impairment in LPF demonstrated the strongest associations with outcomes. Divergent profiles also demonstrated stronger associations with outcomes reported by the informant who had endorsed higher impairment in LPF. Findings suggested that both parent- and child-reported LPF, and the degree of their concordance, may have unique value for predicting clinically important outcomes in pre- and early adolescence. Research and clinical practice utilizing new dimensional approaches with adolescents may therefore benefit from multi-informant assessment of personality functioning.

Objective: This study aimed to Predicting Parental Caregiving Burden Based on Sensory Processing Patterns and Social Skills in Individuals with High-Functioning Autism Spectrum Disorder.

Method: This correlational study recruited a convenience sample of 60 autistic children (aged 5-12 years, IQ > 80) from rehabilitation clinics. Parents completed the Zarit Burden Interview, the Sensory Profile School Companion, and the Gresham and Elliott Social Skills Rating Scale. Data were assessed using Pearson correlation as well as multiple regression analyses.

Results: Sensory processing patterns were positively correlated with parental burden (r = 0.52 to 0.58), while social skills were negatively correlated (r = -0.59). Regression analyses identified significant unique predictors. Sensory Sensitivity (β = 0.28, p = 0.03) and Sensory Avoiding (β = 0.31, p = 0.02) were significant positive predictors of burden. In a separate model, lower Social Skills (β = -0.42, p = 0.003) and higher Problem Behavior (β = 0.28, p = 0.02) significantly predicted greater burden, collectively explaining 41.4% of the variance.

Conclusion: Specific sensory processing difficulties (sensitivity and avoidance) and social-behavioral factors are significant, unique predictors of parental care burden. Interventions targeting these domains may alleviate caregiver stress and improve family outcomes in autism.

Polygenic scores (PGS) have become valuable tools for quantifying genetic liability to complex mental disorders. This review discusses the application of PGS in gene-environment interaction (GxE) research, focusing on depression and stress-related phenotypes. We synthesize evidence from studies testing whether genetic risk, as indexed by PGS, moderates the impact of environmental exposures, particularly stressful life events (SLEs), on psychological outcomes. Findings from large-scale population studies lend partial support to the diathesis-stress framework, with significant GxE effects observed between polygenic risk for depression and various stressors. Individuals with higher genetic liability tend to be more vulnerable to the adverse effects of stress, though effect sizes are typically modest. Some studies report robust interactions, whereas others find independent main effects of genes and environment without meaningful moderation. We further review genome-wide interaction studies (GWIS) aiming to identify variants underlying stress sensitivity and emerging research employing PGS to predict psychotherapy response. Despite methodological advances, the limited variance explained by current PGS constrains their immediate translational value. Overall, we outline both the promise and current limitations of PGS-based GxE approaches and highlight opportunities for improving their utility in elucidating how genetic predisposition and environmental adversity jointly shape risk for mental disorders.

Background: Gene-environment interactions play a critical role in shaping phenotypic heterogeneity in complex psychiatric disorders. Brain-derived neurotrophic factor (BDNF) is a key genetic regulator of stress-sensitive neuroplasticity. Yet, how BDNF polymorphisms are associated with the effect and impact of childhood trauma on clinical phenotypes remains incompletely understood.

Methods: We conducted a case-control study including 93 patients with first-episode schizophrenia (SZ) and 64 healthy controls. Childhood trauma exposure was assessed using the Childhood Trauma Questionnaire (CTQ), and symptom dimensions were evaluated with the Positive and Negative Syndrome Scale (PANSS). Three BDNF single-nucleotide polymorphisms (rs6265, rs2030324, and rs11030101) were genotyped. Generalized linear models were applied to examine gene-environment interaction effects while adjusting for demographic and clinical covariates.

Results: Patients with SZ exhibited significantly higher CTQ scores across all trauma subtypes compared with controls (all P < 0.05). Childhood trauma was associated with increased severity of positive, excitement/hostility, and depression/anxiety symptom dimensions. Importantly, BDNF variants significantly moderated these associations. Rs6265 (CT/TT genotypes) interacted with physical neglect to predict lower depression/anxiety scores, whereas rs11030101 (TA genotype) interacted with sexual abuse to predict increased depression/anxiety and showed negative interactions with physical neglect and total CTQ scores in relation to negative symptoms.

Conclusion: These findings demonstrate that BDNF polymorphisms act as genetic modifiers of trauma-related symptom expression, supporting a gene-environment interaction model underlying phenotypic heterogeneity in schizophrenia.

Background: Cutaneous adverse drug reactions due to antipsychotic therapy are well-documented, although their manifestations are highly variable. Blonanserin, a second-generation antipsychotic, is generally considered to have a favorable tolerability profile. Cutaneous reactions to blonanserin are rare and, more importantly, remain poorly characterized. This case report describes a novel and distinctive presentation of a bilateral hand-restricted drug eruption attributed to blonanserin.

Case summary: A 26-year-old woman without prior psychiatric history was hospitalized for an acute psychotic episode. Treatment was initiated with quetiapine (25 mg at bedtime), and blonanserin (8 mg/day) was added on the fifth hospital day to accelerate symptom control. On the fourth day of combination therapy, the patient developed symmetrical, erythematous papules limited to the dorsal and palmar aspects of both hands, with no history of new topical exposures. Although the rash was initially managed as dyshidrotic eczema or contact dermatitis with antihistamines and potent topical corticosteroids, it worsened over the following week. Given the strong temporal relationship, blonanserin was discontinued on the tenth day after rash onset, while quetiapine was continued. A dramatic improvement was observed within 72 hours, with near-complete resolution within one week. The patient's psychiatric symptoms remained stable on quetiapine monotherapy.

Conclusion: This is the first report of a bilateral hand-limited drug eruption due to blonanserin and underscores that prompt withdrawal upon rash appearance is important for patient comfort and aligns with good clinical practice.

Introduction: More optimistic treatment expectations are typically associated with better psychotherapy outcomes, including in depression. Meta-analytic findings suggest that this relationship is mediated by the dyadic alliance. In settings including group formats, however, patients also interact and build relationships with one another. Thus, group relationship may represent an important mediator, particularly given that depression is often accompanied by interpersonal difficulties. Therefore, we aimed to investigate the potential mediating role of group relationship above and beyond the dyadic alliance, as, to the best of our knowledge, this has not yet been examined. We hypothesized that more optimistic treatment expectations would be both, directly and indirectly associated with better outcomes through a stronger dyadic alliance and better group relationship.

Methods: Data were drawn from a naturalistic observational study at a local day clinic in Switzerland. Patients were assigned to one of two treatment tracks: Cognitive Behavioral Analysis System of Psychotherapy (CBASP) or Short-Term Psychodynamic Psychotherapy (STPP). Fifty adult patients with complex courses of depression were included in the analysis. Treatment expectations were assessed at baseline using the Treatment Expectation Questionnaire (TEX-Q), dyadic alliance within the first weeks using the Helping Alliance Questionnaire (HAQ), and group relationship with the subscale group cohesion of the Inpatient and Day-Clinic Experience Scale (IDES) retrospectively at treatment end. Treatment outcome was quantified as residual change scores on the revised Beck Depression Inventory (BDI-II) from baseline to treatment end. A parallel mediation analysis controlling for treatment track and duration was conducted in PROCESS using bias-corrected bootstrapping.

Results: More optimistic treatment expectations were significantly associated with higher levels of dyadic alliance and group cohesion. However, only group cohesion was associated with outcome, but not dyadic alliance. The direct association of treatment expectations with outcome was non-significant.

Discussion: These findings provide preliminary support for an indirect association of treatment expectations with outcome through group cohesion in depression. However, the results should be interpreted with caution due to several methodological constraints. Future research should replicate these findings in larger samples, with prospective cohesion measurements, and examine temporal dynamics. Clinically, these findings highlight the potential relevance of explicitly addressing treatment expectations and group cohesion.