International Journal of Psychiatry in Clinical Practice最新文献

Objective: The study aims to investigate the prevalence of general medical conditions (GMCs) within a sample of adult with Attention Deficit Hyperactivity Disorder (ADHD) and to ascertain whether such comorbidities may correlate with specific socio-demographic or clinical parameters.

Methods: The sample included 196 outpatients with adult ADHD. Binary logistic regression (LogReg) was used to identify explanatory variables associated with GMC.

Results: Ninety-four subjects (48%) had at least one GMC. ADHD patients with GMCs showed more psychiatric family history (56.7% vs 30.9%), more comorbidities with bipolar spectrum disorders (17% vs 5.9%), and greater impairment in social functioning (67% vs 52.9%). At the LogReg analysis, only the association with psychiatric family history and comorbidity with bipolar disorder remained significant.

Conclusions: We observed a high prevalence of GMC among adult ADHD outpatients. The association found between GMC and a family history of psychiatric disorders allows to hypothesise that there may be a genetic predisposition substrate to both GMC and psychiatric disorders, while the association between GMC and comorbidity with bipolar spectrum disorders can be explained by the tendency of bipolar disorder itself to be associated with GMC. It appears crucial in these patients to perform routine medical examinations and to implement a healthy lifestyle.

Objective: This study compared clinical features, symptom severity, and prenatal/perinatal risk factors in children with regressive (ASD-R) and non-regressive autism spectrum disorder (ASD-NR) in a Turkish paediatric sample.

Method: A retrospective cross-sectional study was conducted with 143 children aged 2-6 years diagnosed with ASD, grouped as ASD-R (n = 29) or ASD-NR (n = 114). Symptom severity was assessed using the CARS, AuBC, and ABC. Data on prenatal and perinatal factors, epilepsy, and parental age were collected.

Results: No significant differences were found in CARS, AuBC, or total ABC scores, except for higher lethargy/social withdrawal scores in the ASD-NR group. Prenatal and perinatal risk factors and epilepsy prevalence were similar. However, parental ages at birth were significantly higher in the ASD-R group. Logistic regression did not yield significant predictors of regression.

Conclusion: The findings suggest that prenatal and perinatal factors may influence developmental regression in ASD when interacting with genetic vulnerability. Longitudinal studies are needed to clarify the role of early environmental exposures and epigenetic mechanisms in regression patterns.

Objective: Loneliness can be defined as a subjective distressing experience that results from perceived isolation or the difference between an individual's preferred and actual social experience. Loneliness is associated with an increase in the incidence of psychiatric and medical disorders and suicidal behaviour. The goal of this article is to attract attention to underappreciated issues of loneliness in veterans and suicidality in lonely veterans.

Methods: A review of the relevant literature.

Results: Military veterans have unique experiences of loneliness, especially older veterans. Suicide in veterans is a major social issue. Studies suggest that loneliness may contribute to suicidality among veterans. Loneliness is a transdiagnostic suicide prevention and intervention target in the veteran population.

Conclusions: Prevention of suicide in lonely veterans should include six components: (1) Recognition of loneliness; (2) Reduction of loneliness; (3) Management of psychiatric and medical disorders; (4) Assessment of suicide risk; (5) Restricting access to the means for suicide; and (6) Specific interventions to reduce suicidality.

Background: Quality of life (QoL) in patients with Schizophrenia has become one of the most important outcome measures in long-term treatment; however, in the Latin American context, longitudinal research that analyzes its trajectories over time and its relationship with clinical and sociodemographic aspects is still scarce. The aim of this study was to longitudinally evaluate QoL in conjunction with psychotic symptomatology, internalised stigma, social cognition, premorbid adjustment, and years of untreated psychosis in a sample of patients with a diagnosis of Schizophrenia in Northern Chile.

Method: A total of 26 patients were able to complete the 10-year follow-up of measures and predictors of stigma, which were evaluated in Public Outpatient Mental Health Centres in the city of Arica between March-July 2012 and March-July 2022. The results show that QoL trajectories improve over time, especially in aspects such as family relationships, autonomy and resilience. On the other hand, depressive symptoms, self-stigma and premorbid adjustment were significant predictors of follow-up measures of QoL.

Discussion: These results underscore the importance of overcoming stigma and depressive symptomatology to improve the QoL of patients with Schizophrenia. Also, the results yielded that premorbid successful psychosocial functioning and experiences are a significant predictor of QoL.

Objective: Creativity is the ability to generate original ideas, solutions and new concepts. This includes divergent thinking, defined as the ability to think outside of established patterns. Research has focused on the link between creativity and schizophrenia, but results are heterogeneous and contradictory. This study examined divergent thinking using the Divergent Thinking Test (DTT), which compared healthy subjects and subjects with a psychiatric disorder, including schizophrenia.

Methods: 48 Patients (schizophrenia, n = 20, psychiatric disorder other than schizophrenia, n = 28) and 38 healthy subjects performed the DTT, which includes five factor scores: fluidity (FL), flexibility (FS), originality (O), elaboration (E), title (T). Linear models were employed for between-group comparisons.

Results: The results indicated that psychiatric patients show a lower performance on the DTT than healthy subjects. Within the patient group, subjects with schizophrenia show greater difficulties than subjects with other psychiatric disorders.

Conclusions: The DTT scores of the control group are higher than those of the psychiatric group. Regarding to the type of diagnosis, performance on the DTT task is lower in schizophrenic patients than in patients with another psychiatric disorder, suggesting the existence of a negative association between creativity and schizophrenia.

These two cases highlight the utility of a focused, structured clinical phenomenological interview in measuring treatment effectiveness in subjective experience. Two male patients, aged 35 and 27, of Serbian ethnicity with treatment-resistant depression were treated with nasal esketamine, with clinical progress monitored using both the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Transdiagnostic Assessment of Temporal Experience (TATE), a structured instrument assessing the patient's felt sense of time. Notably, TATE scores in the first case reached general population levels at week 4, one week prior to the treatment response, as indicated by MADRS. These findings underscore the value of phenomenological assessments in complementing traditional depression scales to capture nuanced improvements during treatment.

Introduction: A legislative amendment regarding seclusion and restraint in psychiatry was enacted in France in 2020, aligning with global efforts to reduce coercive measures in mental health care. This study aimed to evaluate whether the amendment was associated with a change in these clinical practices.

Methods: A single-centre, mirror-image observational study was conducted, analysing data from hospitalised patients subjected to seclusion and/or restraint between May 2018 and September 2023. Sociodemographic and clinical data were compared for patients before and after the legislative change.

Results: The study included 126 patients, with 77 requiring both seclusion and restraint. Results indicated no significant effect of the amendment on the frequency of seclusion (p = .7) or restraint (p = .7). Similarly, no differences were observed in the duration of seclusion (p = .4) or restraint (p = .6). Sociodemographic and clinical characteristics remained consistent between the two periods.

Conclusion: The findings suggest that the legislative amendment was not associated with a change in practices. This highlights the need for complementary strategies such as staff training, institutional initiatives, and resource allocation to effectively reduce coercive measures. Further multicentric and longitudinal studies are recommended to assess the broader and long-term impacts of the law.

Background: Depression is a mood-related disease that affects a person's life. The effects of Ramadan fasting on mental health, including depression, have been investigated in a few previous studies. So, this study examines the long-term association between fasting during Ramadan and depression.

Methods: This was a retrospective cohort study based on the data of the MASHAD (Mashhad stroke and heart atherosclerotic disorder) study. Depression was considered as scores >13 using Beck's depression inventory II (BDI II). The study subjects included three groups of healthy, people who developed depression during follow-up (Dep1-, Dep2+), and people who suffered from depression during study (Dep1+, Dep2+).

Results: A total of 8609 individuals completed the study. There was no significant association between fasting throughout life and Ramadan with the incidence of depression (p > 0.05). However, an earlier age of initiation for the first experience of Ramadan fasting was associated with 8.4% higher incidence of depression (OR: 0.916, CI (0.889-0.944)) in Dep1-, Dep2 + group and 10.7% for Dep1+, Dep2+ (OR: 0.893, CI: (0.861-0.925)) (p < 0.001).

Conclusion: Fasting during Ramadan may not be associated with the incidence of depression, but the lower age of first Ramadan fasting could be related to depression.

Objective: There is a growing concern regarding the increasing trend of emotional and behavioural problems (EBP) in children, alongside rising mental health challenges among Malaysian parents. This study aims to delineate the prevalence of EBP in children attending the child and adolescent psychiatric (CAP) clinic at Hospital Sultan Abdul Aziz Shah and assess the levels of psychological distress in their parents.

Methods: In this cross-sectional study, 125 parents assessed the severity of their children's EBP and their own mental health using validated self-administered questionnaires.

Results: The prevalence of EBP among children was 48.0%, while the prevalence of depression, anxiety, and stress among their parents was 32.8%, 45.6%, and 32.8%, respectively.

Conclusion: In line with global literature, this study emphasises the critical need to address the mental health of parent-child dyads via the implementation of integrated services that manage these intertwined issues.