Journal of psychiatric research最新文献

Mental health challenges among young people are a significant concern in the United Kingdom, with an estimated 16 % of young people experiencing common mental health problems like anxiety and/or depression on any given day, yet only one in four of these are able to access mental health services. This study seeks to identify the key determinants influencing young people's mental health care utilization and to examine the experiences faced by those who do not engage with mental health services, using a co-produced adaptation of Andersen's Behavioral Model of Health Care Utilization to analyze linked health care data from the NEXT STEPS cohort. Imputation addressed missing data, while logistic regression assessed need, enablers, and predispositions influencing care use. Key findings indicate that young people's mental health care utilization is primarily driven by clinically assessed need, while factors such as female gender, presence of psychiatric-level symptoms, limited social support, external locus of control, parental unemployment emerged as weaker predictors of service engagement. Young people with common mental health problems who had not accessed mental health services were less likely than service users to be female, live in single-parent households, have caring responsibilities, or report bullying, but were more likely to report positive parental relationships. Adults who had accessed mental health services as a young person experienced less favourable adult outcomes and quality of life relative to non-users. These findings highlight the need to reform youth mental health care models towards more inclusive, preventative, and holistic approaches.

Background: Despite increased prevalence of alcohol use and alcohol use disorder (AUD) in youth with bipolar disorder (BD), little is known about the clinical correlates of this comorbidity.

Methods: Participants included 250 youth aged 13-20 years with BD (n = 135 with no alcohol use; n = 76 with alcohol use; and n = 39 with lifetime AUD). Multinomial logistic regression examined associations between demographic and clinical characteristics and alcohol use group (reference: no alcohol use), adjusting for age and sex. Binary logistic regression compared the alcohol use and AUD groups.

Results: Relative to youth with no alcohol use, those with alcohol use or AUD had higher rates of drug use disorder, smoking and impulsivity; these were also higher in youth with AUD versus alcohol use. Compared to no alcohol use, youth with alcohol use had higher current mania, whereas youth with AUD were older and had higher rates of oppositional defiant disorder (ODD), conduct disorder (CD), eating disorder, current and lifetime depression, emotional dysregulation and interpersonal problems. Compared to alcohol use, youth with AUD had higher rates of ODD and CD.

Conclusion: In addition to the expected association of alcohol use and AUD with use of other substances, youth with BD and alcohol use or AUD had greater impulsivity. Furthermore, AUD was associated with increased rates of multiple internalizing and externalizing comorbidities. Adverse clinical correlates were significantly more common among youth with AUD vs. alcohol use. Pending findings from longitudinal research, these correlates provide potential prevention and treatment targets to mitigate adverse effects of alcohol.

Characterized by developmentally inappropriate levels of inattention, hyperactivity, and impulsivity, Attention-Deficit Hyperactivity Disorder (ADHD) is the most prevalent neurodevelopmental disorder, posing a significant public health concern. Its etiopathogenesis is considered multifactorial with complex determinism but remains unclear. Recent research highlights the gut microbiota and the gut-brain axis as promising avenues for understanding and potentially treating ADHD, with a growing number of studies exploring alterations in gut microbiota composition among affected individuals. This narrative review examines the current literature on the role of the gut microbiota in ADHD and focuses on key findings about bacterial composition, how it may be linked to ADHD symptomatology, and the possible mechanisms involved. While studies consistently report changes in microbial composition and diversity in individuals with ADHD, results remain heterogeneous across taxonomic levels. Some compelling evidence also suggests a link between gut microbial profiles and ADHD symptom severity. The involvement of microbiota in influencing neurodevelopment is proposed to be mediated through mechanisms related to SCFA production, immune modulation, and neurotransmitter synthesis. These findings pave the way for microbiota-targeted interventions as adjunct therapies for ADHD. This review evaluates areas of consensus and discrepancies between studies, while addressing the methodological limitations present in this field of research. Although the gut microbiota appears to play a meaningful role in the complex and multifactorial origins of ADHD, more rigorous and comprehensive studies are needed to confirm these findings and translate them into effective clinical applications. This could ultimately improve both our understanding and treatment of this heterogeneous disorder.

Study objectives: Sleep disorders are common and impair performance and health. The intestinal microbiome regulates human chronobiology. Microbiome modulation through probiotic intervention might therefore harbor the potential to treat sleep disorders. We tested this hypothesis in a randomized, double-blind, placebo-controlled study.

Methods: We randomized 130 volunteers with self-reported impaired quality of sleep (PSQI>5) in a 1:1 ratio to a 28-day intervention with either a multispecies probiotic (OMNiBiOTiC® STRESS Repair) or a placebo. Participants completed validated questionnaires to estimate quality of sleep, quality of life and perceived stress, and collected stool samples for 16S rRNA sequencing before and after the intervention. Ninety-four participants finished the study and were included in the analysis.

Results: Baseline characteristics were similar between the probiotic group (n = 50; 88.6 % female, 41.2 ± 10.6 years old) and the placebo group (n = 44; 88.0 % female, 40.1 ± 10.7 years old), including the initial PSQI score (10.1 ± 2.7 vs. 10.5 ± 2.6). The probiotic intervention led to an improved sleep efficiency and latency, and thereby improved quality of sleep beyond an observable placebo effect (6.8 ± 2.9 vs. 7.7 ± 3.1; p = 0.036, probiotic and placebo group, respectively). Probiotic bacteria were partially recovered in the microbiome, causing a slight shift in beta diversity in the probiotic group. The intervention did not influence quality of life or perceived stress.

Conclusions: In conclusion, this well-powered RCT shows that the intervention with a multispecies probiotic improved quality of sleep beyond the effect of a placebo intervention, and that the modulation of the microbiome may therefore be of clinical benefit in alleviating sleep disturbances.