Journal of Nervous and Mental Disease最新文献

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.

Introduction: This study explores the correlation between immune inflammation and Alzheimer's disease (AD), focusing on immune-brain interactions impacting neurodevelopment and function.

Methods: Public genetic data were used to analyze 731 immune cell signals, employing two-sample Mendelian randomization, with multiple testing corrected by the Bonferroni-adjusted false discovery rate (FDR).

Results: Six immune phenotypes were identified as significantly increasing AD risk (effect sizes ranging from OR =1.038 to 1.123), including HLA DR on CD33+ HLA DR+ CD14-, HLA DR on CD14+ monocyte, CD4+ CD8dim T cells (% lymphocytes), CD33 on HLA DR on CD14+ CD16- monocyte, CD33 on CD33+ HLA-DR+ CD14dim cells and CD11c on CD62L+ myeloid dendritic cell.

Conclusion: This study confirms the genetic association between specific immune cells and AD, highlighting potential immune-related biomarkers for AD risk.

Aim: Despite knowledge that generalized anxiety disorder (GAD) is associated with increased risk for cannabis use, factors contributing to the co-occurrence of GAD and cannabis use remain understudied. The current study evaluated the contributions of anxiety sensitivity (AS) and intolerance of uncertainty (IU) in terms of cannabis use and coping motives for use in individuals with clinically elevated worry.

Methods: Participants were 220 undergraduate students ( Mage = 19.44, SD = 2.46, range = 18-40; 82.3% female; 89.1% White) who completed self-report measures.

Results: When controlling for sex and negative affect, greater AS, but not IU, was significantly positively associated with greater frequency of past month cannabis use (4.4% variance) and coping motives for use (4.9% variance). AS-Social Concerns was significantly positively associated with coping motives for cannabis use in follow-up analyses (7.1% variance).

Conclusions: Intervention efforts aimed at reducing cannabis use among individuals at-risk for GAD may benefit from targeting AS.

Introduction: Nonsuicidal self-injury (NSSI) represents a relevant public health concern, with lifetime prevalence being high in community samples. The present study aimed to examine the latent associations between the Hierarchical Taxonomy of Psychopathology (HiTOP) superspectra and NSSI frequency and motivation.

Methods: A sample of 547 community-dwelling adult participants was administered measures of NSSI, NSSI functions, and psychopathology.

Results: The multiple indicators multiple causes model evidenced a significant and nontrivial contribution of the Functional Assessment of Self-Mutilation automatic function latent dimension in predicting the frequency of NSSI. Structural equation modeling analyses showed that the overall frequency of NSSI episodes was uniquely, significantly and positively predicted by the HiTOP Externalizing latent dimension scores. Notably, all FASM motivation factors yielded significant and nontrivial relationships with HiTOP Externalizing, Psychosis, and Emotion Dysfunction latent variables in SEM analyses.

Conclusions: These findings may prove useful in extending our knowledge of transdiagnostic psychopathology dimensions and their implications for NSSI.

Objective: We sought to examine the relationship between pastime activities (i.e., activity engagement), social connectedness with family and friends, and severity of Prolonged Grief Disorder (PGD) symptoms across younger, middle-aged, and older adults.

Methods: The participants (N=105) were bereaved individuals who participated in the National Institute of Mental Health (NIMH)-funded Living Memory Home study to determine the risks and benefits of an online tool for bereavement adjustment.

Results: Cross-sectional findings showed that engagement in pastime activities (e.g., travel, sports) was associated with greater social connectedness for older adults, and social connectedness was associated with lower PGD symptom severity. Engagement in pastime activities was associated with lower PGD symptom severity for middle-aged adults.

Conclusions: Results are consistent with the socioemotional selectivity theory and the microsociological theory of adjustment to loss and suggest that grief interventions should have age-specific strategies, encourage specific pastime activities, and promote feelings of social connectedness.