International Journal of Psychiatry in Clinical Practice最新文献

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.

The study aimed to investigate the determinants associated with readmission in first-hospitalised major depressive disorder (MDD) patients with suicide attempts. The study included a cohort of 3977 patients diagnosed with MDD, as retrieved from the hospital information system (HIS). The data were split into a training set and a validation set using R software. To develop a stepwise regression model, the multivariate logistic analysis included significant factors (p threshold <0.2 in univariate analysis).(1) There was a significant difference in the incidence of readmission between first-hospitalised MDD patients with suicide attempts and those without; (2) Length of stay, course of disease, somatic symptoms, psychosis symptoms, anxiety symptoms, alcohol/tobacco dependence, family history of psychiatric disease, continued use of antidepressants combined with antipsychotics or not after discharge, and total bilirubin (TBIL) were included in these variables to build a predictive model in R software; (3) The area under the curve (AUC) was 0.783 for the training set and 0.778 for the validation set. The Hosmer-Lemesho (H-L) test for calibration was p = 0.3521 for the training set and p = 0.8497 for the validation set. The study revealed a significantly increased risk of readmission in first-hospitalised MDD patients with suicide attempts compared to their counterparts.

Introduction: Psychotropic drugs are commonly employed in the treatment of various psychiatric disorders, yet they carry a number of risks due to their potential side effects and interactions with other drugs. Some medical errors in the prescribing of psychotropic medication may have adverse consequences for patients, which may result in physical harm or even death. The objective of this study is to define the processes to be considered by investigating medical malpractice claims related to psychotropic drug treatment.

Method: A retrospective examination was conducted of the sociodemographic and clinical characteristics of medical malpractice cases alleged and reported by the relevant boards of the Turkish Council of Forensic Medicine (2nd Specialised Board, 7th Specialised Board, 8th Specialised Board, and 3rd Supreme Board) between 2013 and 2022.

Results: The majority of cases were male (72%), with an average age of 33.10 ± 16.63 years. The most common diagnosis was schizophrenia (28%), and the most frequent malpractice claims involved the effects of antipsychotic medications (50%). The most common side effects leading to claims were cardiac side effects (34%) in cases that resulted in death (p < 0.001) and extrapyramidal system side effects in other cases (14%) (p < 0.001). It was observed that 29 cases (58%) resulted in death. Antidepressants were more often claimed for causing deaths (p = 0.045), while mood stabilisers were more often claimed for resulting in injuries (p = 0.039). In 81% of non-fatal cases, the clinical side effect in question was determined to be related to the treatment (p = 0.002) and was managed appropriately as a complication (p < 0.001).

Conclusion: Psychotropic drugs can carry serious risks, especially cardiac and extrapyramidal side effects. Careful monitoring and management of these medicines are essential for patient outcomes and safety. These side effects may lead to medical error claims in some cases; however, when managed correctly, they are not considered malpractice.

Objective: The aim of this study was to determine the effects of anxiety levels and emotion dysregulation on each other and their effects on psychosocial functioning in remitted BD patients.

Methods: Sixty-six patients with BD and 38 healthy controls were included in this study. All the patients were assessed with the Hamilton Depression Rating Scale, the Young Mania Rating Scale, the Bipolar Disorder Functioning Questionnaire, the State-Trait Anxiety Inventory (STAI) and the Difficulties in Emotion Regulation Scale (DERS). Healthy controls were only assessed with the STAI and the DERS.

Results: STAI and DERS scores were significantly higher in the patient group than in the control group. Higher scores of STAI and DERS were found to be associated with lower functionality in the patient group. The trait anxiety scores explained 22% of the variance in the psychosocial functionality scores of the patients while the total DERS score explained 51.5% of the variance in the trait anxiety scores. Patients on lithium treatment had less difficulty in regulating their emotions than those on valproic acid treatment.

Conclusions: In light of these findings, planning interventions for emotion regulation difficulties during the management of patients would reduce anxiety levels and contribute to improving patients' psychosocial functionality.

Objective: The aim of this study was to compare adolescents with disruptive mood dysregulation disorder (DMDD) and comorbid attention deficit hyperactivity disorder (ADHD) and healthy control adolescents in terms of emotional intelligence (EI), emotion regulation (ER) and theory of mind (ToM) abilities.

Methods: Twenty-eight adolescents with DMDD and ADHD formed the DMDD group were compared to 31 healthy controls. We administered the Affective Reactivity Index (ARI), Difficulties in Emotion Regulation Scale (DERS), Kiddie-SADS, Bar-On Emotional Intelligence Test, Faux Pas, Comprehension Test, Unexpected Outcomes Test, Faces Test and Reading Mind in the Eyes Test (RMET) as ToM skills.

Results: ARI and DERS scores were significantly elevated in the DMDD-ADHD group. The DMDD-ADHD group had significantly lower ToM skills and emotional intelligence (p < .05). When RMET, Bar-On Emotional Intelligence Test -general mood, DERS- impulsivity scores were compared between the groups, their effect sizes were as follows: 0.52, 0.81, 0.79, respectively. DERS, emotional intelligence and ToM scores were correlated in the DMDD group. In the linear regression analysis, the sole significant predictors of self-reported irritability were EI and ED total scores.

Conclusions: This study suggests that adolescents with DMDD and ADHD face difficulties in peer relationships, mentalizing, various domains of emotional intelligence andregulation. .

Objective: Cognitive Reactivity (CR) is the (re-)activation of negative cognitions by dysphoric mood. We examined whether CR predicts depressive episodes across 2 and 9 years, beyond subclinical depressive symptoms, neuroticism, and previous depressive episodes.

Methods: Participants (N = 1,734) from the Netherlands Study of Depression and Anxiety (NESDA) were never-depressed or remitted-depressed for ≥1 month prior to baseline. We examined 2-year and 9-year predictions using Cox's survival analysis and logistic regression, respectively. Two-year coefficient-based weight-points were calculated and evaluated using ROC analysis.

Results: CR was a statistically-significant predictor of two-year depressive episodes, with an odds ratio of 1.04, 95% CI (1.02-1.06), and over nine years, with an adjusted hazard ratio of 1.01, 95% CI (1.01-1.02). The influence of CR and subclinical depressive symptoms decreased as the number of episodes increased, especially in ≥ 3 past episodes. Calculated weight-points correctly predicted 33.5% of participants who developed 2-year depression, compared to a 17.8% base rate (sensitivity = .81, specificity = .66).

Conclusions: CR is a moderately strong predictor of depressive episodes across 2 and 9 years. In participants with ≥ 3 prior episodes, depression history is such a strong predictor that a ceiling effect occurs, removing any added value of other predictors.