Frontiers in Psychiatry最新文献

Dysphoric Milk Ejection Reflex (D-MER) is a distinct neurobiological condition characterized by negative alterations in mental state in response to milk letdown during lactation. Symptoms vary by patient and can include feelings of sadness, anxiety or agitation. Importantly, the symptoms are brief, typically lasting no more than 5 minutes. Prevalence has been found between 6 and 27% of lactating women, but studies show heterogeneity, due in part to inconsistent definition. D-MER is not currently classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD), which presents a challenge for researchers of the condition. The pathophysiology of D-MER is not well understood, but may be mediated by hormonal changes. In an attempt to begin to formalize classification of this condition, the authors explore the association with another recently classified, hormonally mediated and time sensitive condition: premenstrual dysphoric disorder or PMDD. Like D-MER, PMDD is characterized by heterogeneous symptoms that occur on a predictable timeline. The recent addition of a formal diagnostic category into the DSM helped facilitate an expansion of research into etiology and treatment of the condition. This paper will explore a pathway to classification of D-MER based on the current research using the framework of the DSM-5 diagnostic criteria for PMDD. We will conclude by outlining future research priorities that will help to better define this condition and differentiate it from other causes of emotional distress during lactation.

Purpose: To explore the Effects of Exercise Supplementary to Standard Therapy on Cognition and Sleep in Depression.

Methods: We randomized 273 inpatients with first-episode severe depression, 234 completed 6 weeks, conventional treatment, conventional treatment combined with aerobic exercises and conventional treatment combined with stretching or resistance training exercises group. Hamilton Depression Scale-24 (HAMD24), Pittsburgh Sleep Quality Index (PSQI), Montreal Cognitive Assessment (MOCA), Chinese Version of the Trail-Making Test (C-TMT), and Stroop Color and Word Test (SCWT) were used to evaluate the patients respectively before and after intervention. The primary analysis estimated was the between-group difference in post-treatment scores at 6 weeks under randomized allocation (post-status estimated); within-group changes were summarized descriptively.

Results: After intervention, HAMD24, PSQI, C-TMT-A, and C-TMT-B scores of patients in each group were all lower than those before intervention. HAMD24, PSQI, and C-TMT-A scores of patients in Groups B and C showed lower than those of Group A. C-TMT-B score of patients in Group B was lower than that of Group C, and the score of Group C was lower than that of Group A. MOCA, SCWT scores of patients in each group were higher than those before intervention. Stroop Word and Stroop Color scores were significantly higher in Groups B and C than in Group A. MOCA and Stroop Color-Word scores of patients in Group B were higher than those of Group C. However, scores of Group C were higher than those of Group A.

Conclusion: Both aerobic exercises and stretching or resistance training exercises as adjuncts to conventional treatment improved depressive symptoms, sleep quality, and cognitive function in patients with first-episode severe depression. Patterns were consistent with greater improvement in select executive-function measures in the aerobic arm; confirmation with baseline-adjusted analyses is warranted.

Background: Attention Deficit/Hyperactivity Disorder (ADHD) and internet addiction (IA) are common among college students and often co-exist. This study investigated the relationship between ADHD symptoms, executive dysfunction, insomnia, and IA in Chinese college students.

Methods: A cross-sectional study was conducted in June 2024 at six universities in Hunan Province, China. Demographic data and symptoms of ADHD, IA, executive dysfunction, insomnia, and physical activity were collected via interviews and self-reported questionnaires. Physical activity level was further quantified and categorized using metabolic equivalents (METs) method. Mediation models were performed to explore the path from ADHD to IA and the role of physical activity in IA symptoms.

Results: Among 1925 students, 12.52% had ADHD symptoms, and 14.03% had IA symptoms. ADHD symptoms were related to IA symptoms (total effects: 0.38, p < 0.001; direct effect: 0.111, p = 0.003), mediated by insomnia (0.161, p < 0.001) and executive dysfunction (0.108, p < 0.001). Compared with no physical activity, moderate-level and high-level physical activities were negatively correlated with IA symptoms, with total relative standardized effects of -0.18 (p = 0.001) and -0.42 (p<0.001), respectively. The relative direct effect of high physical activity levels on IA symptoms was -0.29 (p<0.001), regardless of mediation by insomnia (-0.056 (95%CI, -0.094 to -0.021)) and executive dysfunction (-0.067 (95%CI, -0.105 to -0.033)).

Conclusion: ADHD and IA symptoms are prevalent among Chinese college students. Executive dysfunction and insomnia mediate the relationship between ADHD and IA symptoms. Moderate and high-level physical activities were associated with reduced risk of IA symptoms, mediated by executive dysfunction and insomnia. Physical activity may help mitigate IA symptoms in college students.

Background: Transgender and gender-diverse (TGD) individuals face high levels of stigma, discrimination, and psychological distress, which are amplified in carceral settings. Italian prisons have introduced specialized sections for TGD inmates; however, limited empirical evidence exists on their function and the psychiatric, social, and institutional challenges emerging within them.

Methods: A case-informed qualitative design was applied to four TGD inmates housed in a specialized prison section in Northern Italy. Data were derived from routine psychiatric and endocrinological assessments, administrative documentation, informal and semi-structured interviews, and multidisciplinary team observations. A thematic cross-case synthesis was conducted to identify institutional determinants of distress and barriers to gender-affirming care.

Results: Three themes emerged. (1) Context-dependent fluidity in gender identity recognition and categorization: institutional frameworks relied on static binary models, contributing to confusion and psychological strain. (2) Intra-group tensions within designated housing: discrepancies in transition pathways, administrative criteria, perceived authenticity, and the presence of sexual minority inmates generated conflict and social exclusion. (3) Gaps in gender-affirming and psychiatric care: logistical barriers, limited staff training, reliance on telemedicine, and inconsistent access to hormone therapy disrupted continuity of care and exacerbated distress.

Discussion: These findings illustrate how rigid systems and ambiguous housing policies may reinforce minority stress and undermine psychiatric well-being. Protective units can inadvertently reproduce exclusion when gender identity and sexual orientation are conflated or when criteria for placement remain unclear. Correctional systems should adopt flexible gender-recognition procedures, implement trauma-informed practices, develop distinct housing policies, establish standardized pathways for gender-affirming care, and provide specialized staff training to ensure dignity, safety, and improved mental health outcomes for TGD inmates.

Substance use disorder (SUD) poses significant challenges to public health, the economy, and social safety. Delay discounting (DD) is one form of impulsivity which is a risk factor for SUD and other mental health disorders. Moreover, when faced with immediate rewards, individuals with SUD exhibit increased DD compared to healthy controls. Fortunately, previous studies have shown that EFT, referring to vividly imagining potential future events in specific scenarios based on an individual's current experiences, can effectively reduce DD and substance use in individuals with SUD. In this process, the potential regulatory mechanism of EFT may involve extending the temporal window and decreasing the construal level of future events. Most promising avenues to pursue in future studies may include manipulating participants' factors (e.g., sample size, adherence to diagnostic criteria, comorbidity with other mental diseases), conducting longitudinal studies and exploring the neural regulatory mechanisms of EFT on DD among individuals with SUD. Further research should also examine the effects of both positive and negative emotional valence in EFT interventions to determine how different types of future thinking influence impulsivity and decision-making. This would help us develop more applicable theoretical models and improve the effectiveness of EFT in intervening with SUD.

Objective: This study addresses the unclear dynamic mechanisms underlying social interactions in children with autism spectrum disorder (ASD) by constructing a structured play observation framework.

Methods: By combining latent class analysis (LCA) and temporal analysis techniques, this study systematically analyzed the heterogeneous characteristics of social behavioral sequences. Using a longitudinal tracking and cross-sectional design, multimodal data (video coding and physiological indicators) were collected from 60 children with ASD and 40 typically developing (TD) children.

Results: The behavioral sequence complexity of the ASD group was significantly lower than that of the TD group, exhibiting an "avoidance-rigid" cyclical pattern. The LCA model identified three behavioral patterns: high interaction, medium interaction-rigid, and low interaction-high avoidance. The low interaction-high avoidance group demonstrated the poorest intervention response rate.

Conclusion: This study innovatively applies dynamic systems theory to the ASD field, demonstrating that behavioral sequences can serve as intervention targets. It advances evaluation tools from static description to dynamic prediction, providing a scientific basis for personalized intervention planning. The integration of structured observation and multimodal data analysis deepens the understanding of the dynamic mechanisms underlying social impairments in ASD and holds significant theoretical and practical value.

Mental disturbances and related symptoms in the perinatal period present a challenge to patients and providers alike, particularly regarding identification and appropriate management. Perinatal Mental Health (PMH) screening occurs in clinical settings on a more regular basis thanks to guidelines recommending the use of validated screening measures used at perinatal visits. However, patients report several concerns when completing these screeners and providers report barriers in addressing the results. To address barriers and enhance the PMH screening experience, our team of clinicians and researchers propose a tool - the PMH Connect: a Perinatal Mental Health Screening Connection, Education, and Decision Aid - to be given to the patient at the same time as a PMH screener. The PMH Connect provides brief anticipatory guidance about PMH symptoms, normalizing trauma-informed language about prevalence, and provides a connection to resources in a supportive, unobtrusive manner. PMH Connect helps patients feel heard and supported and provides resources before patients need them, which decreases the burden on patients and providers alike. Inspired by the Cycle to Respectful Care framework, PMH Connect is designed to shift power to patients themselves, as valued experts on their own care team, by offering them connections to information and resources through this simple tool. Our hope is that PMH Connect will bridge many of the barriers to effective PMH screening, assessment, and treatment by improving patients' experiences and outcomes with the ultimate goal of optimizing screening effectiveness and care connection to improve maternal and infant health.

Introduction: Mental disorders are a major global public health issue that affects millions of people. Since its creation, the Mental Health Literacy Scale (MHLS) has been employed worldwide in mental health literacy studies.

Methods: The study that is the subject of this paper, was divided into two phases: the first phase involved translating and adapting the MHLS survey questionnaire to the cultural background and the second phase concerned testing the psychometric properties of the Polish version of the MHLS-PL questionnaire on 212 nursing students.

Results: The Polish version of the MHLS-PL questionnaire consists of 33 items, and through confirmatory factor analysis, a single-factor model (Cronbach's α coefficient was 0.93) and a five-factor model (Cronbach's α coefficient ranged from 0.61 to 0.93) were identified. The mean total MHL score among the students under the study was 117.11 (SD = 16.70). With regard to the five-factor model, respondents obtained the highest score on the "Attitudes that promote recognition and appropriate help-seeking" subscale (M = 59.44, SD = 11.03) and the lowest score on the "Knowledge of risk factors and causes" subscale (M = 6.04, SD = 1.33). In the multivariable model, the independent predictors of the MHLS-PL scale were age, education level and interaction with persons diagnosed with mental disorders during the respondent's studies.

Conclusion: The study showed that the 33-item MHLS-PL scale, which includes five subscales, is a reliable and accurate instrument for assessing mental health literacy.

Background: The mental health of medical professionals has garnered increasing attention in recent years. This study aims to explore the relationships and interactions among workplace ostracism, work-family conflict, and sense of coherence (SOC) within this population.

Methods: From January 2022 to December 2023, a survey was conducted involving 527 medical staff from three diverse hospitals. The research utilized the Work-Family Conflict Scale, the Workplace Ostracism Scale, and the Sense of Coherence Scale. Descriptive statistics and correlation analyses were performed on the collected data. Additionally, mediation analysis was employed to assess indirect effects, utilizing bootstrap sampling to estimate confidence intervals for these mediated effects. Simple slope analysis was also conducted to interpret significant interaction effects within moderation models.

Results: A significant positive correlation was found between work-family conflict and workplace ostracism (correlation coefficient = 0.613; P < 0.001). Furthermore, sense of coherence partially mediates the relationship between work-family conflict and workplace ostracism (β = 0.330; P < 0.001). As levels of sense of coherence increase, the impact of work-family conflict on workplace ostracism diminishes progressively.

Conclusion: Work-family conflict is a significant positive predictor of workplace ostracism among medical staff; moreover, sense of coherence serves as a mediator in this relationship-an effect that is particularly pronounced among those with lower levels of sense of coherence.

The precise pathophysiological mechanisms underlying major depressive disorder (MDD) remain poorly understood. Substantial evidence implicates immune-mediated mechanisms in the pathogenesis of this clinically heterogeneous and multifactorial disease. This review provides a comprehensive synthesis of current knowledge regarding the association between inflammation and depression, critically evaluates established approaches for modeling inflammation-induced depressive states in both rodents and humans, and assesses these models against standard validity criteria. The empirical link between depression and immune dysregulation is supported by several key lines of evidence: elevated circulating cytokine levels in MDD patients, the induction of depressive symptoms during therapeutic administration of pro-inflammatory cytokines, the significant comorbidity of MDD with chronic inflammatory diseases, the anti-inflammatory properties of conventional antidepressants and the alleviation of depressive symptoms during anti-inflammatory therapy. Various immune activators are employed to model inflammation-associated depression. Experimental human models primarily utilize lipopolysaccharide (LPS) administration or typhoid vaccination. Corresponding rodent models employ LPS, direct administration of pro-inflammatory cytokines, or immunization with BCG vaccine. In rodent models, the administration of classical antidepressants effectively attenuates the severity of depressive-like behaviors induced by LPS. The predictive validity of the LPS-induced depression model is further corroborated by the demonstrated antidepressant-like efficacy of the rapid-acting agent ketamine. Data on the effects of antidepressants within controlled experimental inflammatory models in humans remain scarce and the impact of novel rapid-acting agents like ketamine and psychedelics in this context remains entirely unexplored. Human experimental studies demonstrate high consistency and reproducibility regarding LPS dosing, experimental timelines, and symptom assessment. Conversely, rodent studies exhibit significant heterogeneity across these same parameters. A major limitation shared by most existing inflammatory models, in both humans and rodents, is their non-chronic nature and the development of tolerance with repeated inducer administration. A critical translational challenge lies in establishing the homology between behavioral outcomes in rodents and the clinical symptomatology of human depression. The development of refined inflammatory models of depression that more rigorously satisfy established validity criteria is imperative. Such models are crucial for elucidating the underlying pathophysiological mechanisms of the disorder and for facilitating the discovery of novel, effective pharmacotherapies.