Frontiers in Psychiatry最新文献

Introduction: The incorporation of motivational strategies has shown promising results in increasing the effectiveness of intervention programs for intimate partner violence perpetrators, such as enhancing treatment adherence and decreasing risk of intimate partner violence recidivism. This could be particularly important for participants with alcohol and/or other drug use problems (ADUPs), who are at higher risk of recidivating and dropping out from the intervention. Consequently, there is a need to study whether motivational strategies are also effective for high-risk and highly resistant participants. The aim of this study was to determine whether the incorporation of motivational strategies led to improved outcomes in participants with ADUPs compared to those without.

Methods: Participants were intimate partner violence male perpetrators who received a standard intervention (n = 349) or a standard intervention adding an individualized motivational plan (n = 367). Data on official intimate partner violence recidivism, intervention dose, and dropout were collected after the end of the intervention. Comparisons were made between participants with and without ADUPs in each intervention condition.

Results: Results showed that in the full sample of participants, irrespective of their condition, those with ADUPs presented a higher recidivism (p = .007) and dropout rate (p = .003) and lower intervention dose than those without ADUPs (p = .005). When only considering participants in the standard intervention, results also showed that intimate partner violence perpetrators with ADUPs had a higher recidivism (p = .025) and dropout rate (p = .015) and lower intervention dose (p = .048) than those without. However, there were no significant differences between participants with and without ADUPs in the standard intervention adding an individualized motivational plan.

Discussion: When incorporating motivational strategies into the standard interventions for intimate partner violence perpetrators, disparities between participants with and without ADUPs were mitigated. Specifically, participants with ADUPs showed similar outcomes to those without ADUPs after receiving the standard intervention adding an individualized motivational plan. Our results suggest that motivational strategies may be effective in reducing intimate partner violence recidivism and improving treatment adherence in high-risk and highly resistant intimate partner violence perpetrators.

Background: Recent studies have identified a correlation between inflammation and depression. This study aims to explore the correlation between the red blood cell distribution width (RDW) to albumin ratio (RAR), a practical measure for assessing inflammation, and depression in the general population.

Methods: In this population-based cross-sectional study, data from 28932 adults aged≥18 years old in the NHANES during the period of 1999-2018 were analyzed. To examine the correlation between RAR and depression, multivariate logistic regression analyses, subgroup analyses, restricted cubic spline analyses, and interaction tests were conducted. Furthermore, a mediation analysis was performed to elucidate the role of atherogenic index of plasma (AIP) in mediating the effect of RAR on depression.

Results: Multivariate logistic regression analyses and restricted cubic splines analysis indicated that RAR can exhibit a linearly correlation with depression (OR = 1.335; 95% CI: 1.222, 1.458). Subjects in RAR Q2, Q3, Q4 groups had an increased risk on depression as 22.8%, 22.9% and 51.9% than those in the Q1 group. This positive correlation was more pronounced in those with history of cancers. The ROC analysis indicated that the area under the curve (AUC) for RAR (AUC=0.593) was significantly greater than that for RDW and albumin individually. Mediation analysis indicated that AIP mediated 7.8% of the correlation of RAR with depression.

Conclusions: The findings of this study indicated a significant linear positive correlation between RAR and the prevalence of depression, with AIP serving as a mediator.

Aims: Menopausal women often suffer from depression, which impairs their quality of life. Physical activity has been reported to exert beneficial effects on preventing and treating depression. This meta-analysis aims to explore the effect of leisure-time physical activity on determined depression or depressive symptoms in menopausal women.

Methods: Relevant studies were searched from PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CINAHL Plus, China National Knowledge Infrastructure (CNKI), VIP, and WanFang databases. Outcomes were depression or depressive symptoms. Weighted mean difference (WMD) or standard mean difference (SMD) with 95% confidence interval (CI) was used as the statistical measure. Heterogeneity tests were performed for each outcome, and all outcomes were subjected to sensitivity analysis. Subgroup analysis was performed based on depression degree, exercise intensity, exercise form, intervention duration, supervision, sample size, and geographical region.

Results: A total of 17 studies were included in this meta-analysis. The results showed that exercise alleviated the depressive symptoms of menopausal women (SMD = -1.23; 95% CI, -2.21 to -0.24). In addition, exercise was found to reduce the depression (SMD = 11.45; 95% CI, -1.75 to -1.15), and depression assessed by the Center for Epidemiologic Studies Depression Scale (CES-D) (WMD = -5.76; 95% CI, -6.63 to -4.89) or Self-Rating Depression Scale (SDS) (WMD = -6.86; 95% CI, -9.24 to -4.49). The results were similar regardless of depression degrees, exercise intensity, intervention duration, exercise form, supervision or not, sample size, and geographical region.

Conclusions: Leisure-time physical activity may help alleviate depressive symptoms or depression in menopausal women. However, further high-quality studies are needed to confirm these findings and better understand the specific effects of physical activity on depression in this population.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42024581087.

Background: Converging evidence suggests that bipolar disorder (BD) involves mitochondrial dysfunction and prefrontal cortex (PFC) hypometabolism associated with cognitive impairment, which persists in remitted BD individuals. Transcranial infrared laser stimulation (TILS) provides safe, non-invasive brain stimulation that enhances PFC metabolism via photobiomodulation of mitochondrial respiration and tissue oxygenation. We tested the hypothesis that the neurocognitive deficits found in BD may be ameliorated by TILS treatments.

Methods: This is the first study to explore neurocognitive effects of repeated TILS administration in BD. Using an open-label design, 29 individuals with remitted BD received six weekly TILS treatments. Working memory and attention were assessed with trail-making and 2-back tasks sensitive to TILS cognitive effects in individuals with BD. Changes in PFC network interactions were measured with functional near-infrared spectroscopy (fNIRS) because this method can measure TILS effects on oxygen metabolism in the PFC of individuals with BD.

Results: Participants reported no adverse effects from treatment, confirming the safety of this intervention in individuals with BD. Cognitive test results showed that in people with remitted BD, TILS was effective at improving cognition, i.e., enhanced speed and accuracy in tasks reflecting cognitive flexibility, working memory, and attentional control. Antipsychotic medication improved TILS cognitive effects. The fNIRS results showed a significant reduction in PFC network correlations of oxygenated hemoglobin changes driven by cognitive task performance. The right-hemisphere frontopolar cortex showed greater TILS effects than its left-hemisphere counterpart.

Conclusions: Repeated TILS is a safe intervention to improve cognition in people with remitted BD. Continued antipsychotic medication may have contributed to the cognitive improvement. To confirm TILS efficacy, a sham-controlled, double-blinded randomized trial is needed.

Clinical trial registration: https://clinicaltrials.gov/, identifier NCT05354895.

Introduction: The prevalence of Generalized Anxiety Disorder (GAD) has increased rapidly, highlighting the importance of its detection using quick tools applicable to men and women from different countries.

Objective: To analyze the psychometric properties of the Generalized Anxiety Disorder Test (GAD-7) by gender and country in Latin America and the Caribbean (LAC).

Method: A cross-sectional e-health study with 12,124 participants from 15 LAC countries (54.32% women, 45.68% men) was conducted, including participants from Argentina (7.3%), Bolivia (6.7%), Colombia (10.3%), Chile (6.9%), Costa Rica (4.9%), El Salvador (5.7%), Ecuador (7.2%), Guatemala (4.7%), Panama (5.1%), Paraguay (5.7%), Peru (8.6%), Puerto Rico (5.8%), the Dominican Republic (6.6%), Uruguay (6.3%), and Venezuela (8.2%). All participants completed the GAD-7 scale digitally.

Results: A unidimensional structure of the GAD-7 was confirmed, explaining 70% of the variance. The model fit indices were adequate (RMSEA = 0.062; CFI = 0.997; TLI = 0.995; SRMR = 0.017; p < 0.001), and the factor loadings for each item were satisfactory (> 0.70). Additionally, the factor structure showed measurement invariance between genders and countries, with adequate fit indices at all levels (configural, metric, scalar, and strict), suggesting that the measurements are equivalent in both contexts. Finally, the internal consistency of the GAD-7 was high, with a McDonald's Omega coefficient of 0.91.

Conclusions: The GAD-7 exhibits a factor structure that is equivalent across genders and countries, demonstrating its validity and reliability for the rapid detection of GAD symptoms in different countries within the region.

Background: Cognitive rigidity and working memory impairment are established features of internalizing syndromes. Growing evidence suggests that deficits in affective control -cognitive control in the context of emotion - may underpin elevated emotion-related impulsivity in various psychiatric disorders.

Objective: This study examines two components of affective control (affective flexibility and emotional working memory) as potential neurocognitive processes linking emotion-related impulsivity to internalizing psychopathology.

Method: Undergraduate participants (analysis n = 120) completed the Memory and Affective Flexibility Task (MAFT), a novel behavioral assessment designed to assess hot cognition in affective flexibility and emotional working memory performance, alongside self-report measures of impulsivity and symptoms of internalizing disorders.

Results: Structural equation modeling suggested that less accurate working memory during neutral trials (cool cognition) was associated with more symptoms of internalizing psychopathology. However, effects of hot working memory and affective flexibility were not significantly related to emotion-related impulsivity or psychopathology scores.

Conclusions: Although findings provide no support for the validity of MAFT indices of hot cognition, these results replicate and extend work on the importance of cool working memory and emotion-related impulsivity as correlates of psychopathology.

Background: Adjustment disorder (AD) is common among medically ill patients, yet current evaluation methods do not address the specific characteristics in this population. This study aimed to develop a measurement scale for AD in medically ill patients in Colombia and to find evidence of its validity and reliability.

Methods: This was a scale development and validation study. In the first qualitative phase, items were developed. In the second phase, the content validity of each item was evaluated by patients and clinicians. In the third phase, structural validity, internal consistency, test-retest reliability, criterion validity, and convergent construct validity were assessed. Items were analyzed using a generalized partial credit model within an item response theory framework.

Results: The Adjustment Disorder Scale for Medically Ill Patients (ETAM, for its acronym in Spanish) was developed, comprising 20 items that address the free description of stressful situations in the last 15 days and mental symptoms attributed to them. Evidence of content validity was found. The scale was administered to 512 medically ill patients, revealing a three-dimensional structure: 1) "AD Symptoms", 2) "Impact on Self-Care", and 3) "Impact on Desire to Live". Internal consistency was adequate, with McDonald's omega of 0.95 and Cronbach's alpha between 0.82 and 0.92 for its dimensions. ETAM had high test-retest reliability (intraclass correlation coefficient of 0.98). Criterion validity evidence was obtained with an independent psychiatrist's diagnosis, with an AUROC of 0.99, and convergent validity was consistent with hypotheses of correlation with other instruments with similar constructs. Discrimination and difficulty parameters were calculated for each item.

Conclusion: The ETAM is a scale with evidence of validity and reliability that can be used for the diagnosis of AD in medically ill patients in Colombia.

Introduction: Randomized controlled trials require diverse patient groups to ensure broad applicability of results. However, gender minorities are often not included, which affects the generalizability and equity of healthcare outcomes. Inclusive research must consider the diversity of sex and gender to eliminate inequalities and improve health outcomes.

Methods: A two-stage expert survey was conducted using a self-developed questionnaire in which the constructs of sex, gender, and gender expression were considered. Experts rated the importance and practicality of assessing these concepts in clinical trials and evaluated terms for suitability and comprehension. In addition, existing definitions were refined. Consensus was defined as 70% agreement or disagreement.

Results: 14 out of 17 participating experts agreed on the importance to independently assess sex assigned at birth, and 9 out of 16 emphasized this for gender identity in clinical trials. Sex should be assessed with "Please specify your sex assigned at birth" and the answer categories "female", "male", "intersex". Gender identity should be assessed with "I identify as…" and the answer categories "woman", "man", "nonbinary", "trans woman", "trans man", "genderqueer", "genderfluid", "agender", "two spirit". Assessment of gender expression depends on the research question and may not be relevant for every study.

Discussion: Our findings emphasize inclusivity by providing multiple gender options and improve data accuracy by allowing individuals to accurately report their gender identity. The results emphasize the importance of distinguishing between sex assigned at birth, gender identity, and gender expression in research. This ensures that gender diversity is accurately represented and considered, improving the relevance and inclusivity of clinical trials.

Background: The assessment of clinical prognosis in autoimmune encephalitis: Girona (ACPE-Gi) score is a scale for evaluating the severity in the acute phase of autoimmune encephalitis (AE) and predicting the risk of disability at 3 months, measured by modified Rankin scale (mRS).

Methods: Patients were strictly diagnosed with AE according to the current criteria between 1 January 2009 to 31 March 2023 at the University Hospital Dr. Josep Trueta of Girona, Catalonia, Spain. ACPE-Gi score included 14 items, and every item was scored from 0 to 3, depending on their severity with a sum ranging from 0 to 41.

Results: ACPE-Gi score measured the severity in the acute phase and grouped the patients into three groups: mild (<8; 32%), moderate (8 to 15; 60%), and severe (>15; 8%). We found that the third group had a higher risk of disability compared with the first group (p = 0.035). We identified that the mean initial score was significantly higher in the group of patients who had higher mRS at 3 months compared to that in the group of patients who had a mild to moderate disability level (mRS ≤ 2) at 3 months (p = 0.023). In addition, autonomic symptoms and mental status impairment demonstrated to be independent risk factors to predict disability (p < 0.05).

Conclusions: The ACPE-Gi score seems to be a reliable scale for comprehensively evaluating the severity of AE in the acute phase and predicting the risk of disability at 3 months. Dysautonomia and altered mental status predict a poorer prognosis in patients with AE.