Journal of Nervous and Mental Disease最新文献

Aim: The role of mental disorders as risk factors for mild cognitive impairment (MCI) remains underexplored. Previous studies often focused narrowly on mental disorders, overlooking comorbidities among psychiatric patients.

Methods: Utilizing a nationwide cohort from 2009 to 2020, this study analyzed 2,717,131 individuals aged 40 years and above. Cox proportional hazards regression analysis was used to determine associations of mental disorders (depressive disorders, bipolar and related disorders, schizophrenia, anxiety disorders, insomnia) and the risk of MCI.

Results: Any mental disorder was associated with a 50% increased risk of MCI (HR: 1.50; 95% CI: 1.48-1.51), except for schizophrenia, which did not significantly alter the MCI risk (HR: 1.08; 95% CI 0.92-1.25). Individuals with a single diagnosis exhibited heightened MCI risk even when participants with multiple diagnoses were excluded (HR: 1.43; 95% CI: 1.41-1.45).

Conclusions: Our findings advocate for a comprehensive approach addressing both disorder types and further cognitive deterioration.

Introduction: Social exclusion affects patients with schizophrenia (SCZ) both because of a fundamental disposition to introversion and through social discrimination. Here, we explore the emotional and cardiac autonomic responses to ostracism using a ball-tossing experiment.

Methods: Through a cross-sectional design, 30 patients with SCZ and 30 healthy controls (HC) performed the Cyberball task. We measured respiratory sinus arrhythmia (RSA) at baseline, immediately after each gameplay (inclusion and ostracism) and after 10 minutes (reflective stage), as well as self-reported ratings of threats toward one's fundamental need to belong.

Results: Participants with SCZ showed reduced RSA at baseline, which remained low for the task's entire duration, regardless of the experimental condition. When excluded, they self-reported a lower sense of threat to fundamental needs, as compared with HC.

Conclusions: Patients with SCZ showed a persistent defensive autonomic state and displayed a blunted emotional response to experimental ostracism, suggesting difficulties in activating social engagement strategies.

Introduction: The relationship between violence and schizophrenia spectrum disorders (SSDs) is complex and poorly understood. Moreover, violence takes different trajectories, depending on its onset relative to that of the illness. However, the effect of such trajectories on the illness is not fully understood in nonforensic populations.

Methods: Two hundred twenty-three participants with SSD were recruited and divided into different violence subgroups using the Brown-Goodwin scale. Psychotic, affective, cognitive, and functional outcomes were measured.

Results: Subgroups only significantly differed in psychotic outcomes, such as paranoia (p=.044), measured by the Symptoms Checklist Scores (SCL-90). Pair-wise analysis revealed that those with childhood and adulthood violence displayed significantly higher paranoia, compared with the nonviolent group (p=.015). However, this was not significant after correcting for multiple comparisons.

Conclusions: Different violence trajectories are associated with different symptomatic outcomes in SSD. This suggests an interplay between violence and psychosis, which is important for comprehensive treatment approaches.

Introduction: Sexual violence is a major public health issue associated with poorer mental health and greater alcohol use problems. Limited work has examined the underlying constructs that may help explain risk for these outcomes among those with a history of sexual violence and probable posttraumatic stress disorder (PTSD) who engage in hazardous drinking (heightened alcohol consumption that increases risk for negative consequences).

Methods: The present investigation evaluated anxiety sensitivity and pain-related anxiety as correlates of mental health and clinically significant alcohol use processes among 133 persons (83 persons identified as female and 96 persons identified as White) with a history of traumatic sexual assault who engaged in hazardous drinking.

Results: Anxiety sensitivity was associated with severe mental health problems, whereas pain-related anxiety was related to alcohol use processes.

Conclusions: Findings suggest that specific transdiagnostic constructs may be important to understanding mental health and alcohol use processes among this population.

Introduction: There is debate as to whether phase-based treatment approaches add value beyond standard trauma-focused treatment protocols for individuals with posttraumatic stress disorder (PTSD). This systematic review examined the efficacy of phase-based treatments for adults with childhood trauma.

Methods: A systematic search of PubMed, Embase, PTSDpubs, and PsycINFO identified randomized controlled trials of phase-based interventions for PTSD symptoms in adults with childhood trauma. Four studies comprising a total of 356 participants met the inclusion criteria. A random effects meta-analysis estimate of the pooled effect size was calculated.

Results: A small-sized positive effect for phase-based approaches over comparator interventions was indicated (Hedges g=0.17; SE=0.12). The pooled odds of completing treatment were not significantly different between phase-based and comparison interventions (OR=0.84, 95% CI: 0.41-1.72).

Conclusions: Our review did not identify advantages of phase-based approaches when compared with trauma-focused therapy alone among the few studies to date.

Introduction: Epilepsy is associated with increased schizophrenia risk, but few large studies account for key factors. This study analyzed cohort data from Korea to assess schizophrenia risk postepilepsy diagnosis.

Methods: Epilepsy patients were age-matched and sex-matched with controls. Schizophrenia was the primary outcome. Cox regression estimated adjusted hazard ratios (HRs), accounting for demographics and lifestyle factors (smoking, BMI, cholesterol, and income). Kaplan-Meier curves and log-rank tests assessed cumulative schizophrenia incidence.

Results: The study included 2,770 epilepsy patients and 27,700 matched controls. The overall adjusted HR for schizophrenia among epilepsy patients was 9.44 (95% CI, 6.72-13.25). Subgroup analysis indicated the highest HR in men under 60 years at 13.44 (95% CI, 5.53-32.66), and in women aged 60 and older at 13.16 (95% CI, 7.09-24.44).

Conclusions: Epilepsy increases the risk of schizophrenia, especially in younger men and older women, highlighting the need for targeted mental health monitoring and early intervention.

Introduction: Smoking is a known risk factor for dementia, but the effects of changes in smoking behavior after a depression diagnosis remain unclear.

Methods: We conducted a nationwide cohort study of 1,290,530 individuals newly diagnosed with depression in South Korea between 2009 and 2012. Participants were categorized by smoking status before and after diagnosis. Incident dementia, including Alzheimer disease (AD) and vascular dementia (VD), was tracked through 2018. Adjusted hazard ratios (HRs) were estimated using Cox models.

Results: Continued smoking showed the highest dementia risk (HR 1.338 for all-cause; 1.323 for AD; and 1.524 for VD). Quitting reduced risk but remained higher than in persistent non-smokers. Middle age was a key risk period for AD. For VD, men had consistently higher risk, while women had increased risk only in the cessation group.

Conclusions: Changes in smoking behavior after depression diagnosis influence dementia risk, underscoring the need for cessation strategies.

Introduction: The DSM has made advances in helping clinicians address cultural factors important in psychiatric care, including the acknowledgement of religious and spiritual problems that impact a patient's mental health. However, moral problems have been under-recognized as a culturally contextualized source of negative consequences for occupational, social, and other areas of functioning.

Methods: To recognize the clinical significance of moral problems, an expanded DSM Z-code diagnostic category entitled "Moral, Religious, or Spiritual Problem" was recently approved.

Results: In light of this development, this paper reviews the conceptual and empirical connections with regard to moral, religious, and spiritual problems. A definition of moral problems is presented in relationship to transgressions of an individual's moral identity, which may include moral dilemmas, moral distress, and moral injury.

Conclusions: Various differential diagnostic issues are raised related to this expanded Z-code, as well as potential implications for clinical practice, public health, and future research.

Introduction: This study examined the relationship between childhood trauma, alexithymia, and theory of mind (ToM) skills in patients with borderline personality disorder (BPD).

Statement of study type: This study is a cross-sectional, randomized controlled survey/scale study.

Methods: Ninety participants were divided into three groups: BPD patients with high trauma levels (n=30), BPD patients with low trauma levels (n=30), and healthy controls (n=30). Assessments included the Childhood Trauma Questionnaire (CTQ-28), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Toronto Alexithymia Scale (TAS-20), Reading the Mind in the Eyes Test (RMET), and a sociodemographic form.

Results: BPD patients had significantly higher childhood trauma exposure (p<.001), alexithymia (p<.001), and lower ToM skills (p<.001) than controls. No significant relationship was found between trauma scores and alexithymia (p=.937) or ToM skills (p=.461) within the BPD group.

Conclusions: Findings suggest that BPD itself may impair ToM skills independently of childhood trauma and alexithymia.

Introduction: This study examined adult psychiatric inpatients diagnosed with diabetes or hypertension before admission who then had these diagnoses missing from discharge records.

Methods: We analyzed Medicaid records for adults admitted to inpatient psychiatry in New York State hospitals between 2012 and 2013. We included 6,381 patients with records indicating preexisting diabetes or hypertension in the 12 months before admission. Logistic regression analyses identified factors at the patient, hospital, and system levels related to detection or omission of the diagnosis of diabetes or hypertension upon hospital discharge.

Results: Preexisting diabetes or hypertension was missed in 29% and 36% among inpatients, respectively. Diagnoses were more frequently missed in people who were younger, experiencing homelessness, with fewer claims and with claims longer than 30 days before admission.

Conclusions: These findings underscore the importance of comprehensive admission processes in inpatient psychiatric settings to ensure appropriate detection and treatment of medical comorbidities.