Journal of psychiatric research最新文献_第3页

Defining treatment response in gambling disorder 确定赌博障碍的治疗反应。

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2024-11-04 DOI: 10.1016/j.jpsychires.2024.11.006

Jon E. Grant , Konstantinos Ioannidis , Samuel R. Chamberlain

Background

Gambling disorder is a common mental health condition, and a growing cause of concern globally. Despite the availability of well-validated self-report and clinical instruments to measure symptom severity, there has been no study to establish optimal thresholds for determining treatment response based on these measures.

Methods

Data from 553 participants (aged 18–65 years) who had participated in previous pharmacological and psychotherapeutic clinical trials for gambling disorder were aggregated. Studies were included that collected Clinical Global Impression Improvement (CGI-I) at end-of-study (reference standard), as well as baseline and end-of-study symptom severity using the Gambling Symptom Assessment Scale (GSAS) and/or the Yale-Brown Obsessive-Compulsive Scale Modified for Pathological Gambling (PG-YBOCS). Receiver Operator Characteristic (ROC) analyses were conducted to identify optimal thresholds for determining treatment response.

Results

Greater than 50% improvement in PG-YBOCS and 35% improvement in GSAS were the optimal thresholds for defining treatment response. For the PG-YBOCS, the cutoff had acceptable sensitivity and specificity (85.0%, 83.0%) and area under the curve of 0.904. For the GSAS, the cutoff had acceptable sensitivity and specificity (81.2%, 73.4%), and area under the curve of 0.859.

Conclusions

This study provides useful thresholds on two widely used, valid outcome measures for gambling disorder, in terms of determining treatment response or absence thereof. These thresholds may be useful for clinical practice at the level of individual patients, but also for future clinical trials.

背景：赌博障碍是一种常见的精神疾病，也是全球日益关注的问题。尽管有经过充分验证的自我报告和临床工具来测量症状的严重程度，但还没有研究根据这些测量方法来确定治疗反应的最佳阈值：方法：汇总了 553 名参与者（年龄在 18-65 岁之间）的数据，这些参与者曾参加过针对赌博障碍的药物和心理治疗临床试验。纳入的研究收集了研究结束时的临床总体印象改善（CGI-I）（参考标准），以及使用赌博症状评估量表（GSAS）和/或耶鲁-布朗病态赌博强迫量表（PG-YBOCS）评估的基线和研究结束时的症状严重程度。通过接收器特征（ROC）分析，确定确定治疗反应的最佳阈值：结果：PG-YBOCS 的改善幅度超过 50%，GSAS 的改善幅度超过 35%，是确定治疗反应的最佳阈值。就 PG-YBOCS 而言，该临界值具有可接受的敏感性和特异性（85.0%、83.0%），曲线下面积为 0.904。对于 GSAS，临界值具有可接受的敏感性和特异性（81.2%、73.4%），曲线下面积为 0.859：本研究为两种广泛使用的、有效的赌博障碍结果测量方法提供了有用的临界值，以确定治疗反应或无反应。这些阈值可能对个别患者的临床实践有用，也可能对未来的临床试验有用。

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引用次数: 0

A self-guided virtual reality solution for social anxiety: Results from a randomized controlled study 社交焦虑症的自我指导虚拟现实解决方案：随机对照研究的结果

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2024-11-04 DOI: 10.1016/j.jpsychires.2024.10.032

Cameron Lacey , Chris Frampton , Ben Beaglehole

Objective

The study examines the efficacy of a mobile application, oVRcome, which offers self-managed virtual reality exposure therapy combined with cognitive-behavioural techniques to treat social anxiety disorder.

Methods

A randomized controlled trial (RCT) was conducted over six weeks with a waitlist delayed treatment group and follow-ups at 12 and 18 weeks. Participants were adults living in New Zealand with moderate to severe social anxiety disorder, as measured by the Liebowitz Social Anxiety Scale (LSAS). The primary focus was on the change in LSAS scores from baseline to the sixth week. All analyses utilized the intention-to-treat data.

Results

Out of 126 randomized participants, 81 completed the six-week follow-up. The retention rate at week 6 was 67.5%. The reduction in LSAS scores was significantly greater in the active group compared to the waitlist delayed treatment group (active group mean = −35.7 [SD = 24.0]; waitlist group: mean = − 2.2 [SD = 13.5]; p < 0.001), for an effect size of 1.8.

Conclusions

The study demonstrates that oVRcome can effectively reduce social anxiety symptoms, offering a viable self-guided treatment option.

Trial registry

ClinicalTrials.gov ID NCT05576259.

研究目的本研究探讨了一款名为 "oVRcome "的移动应用程序的疗效，该应用程序提供自我管理的虚拟现实暴露疗法，并结合认知行为技术来治疗社交焦虑症：随机对照试验（RCT）为期六周，治疗组为等待名单延迟治疗组，随访时间为12周和18周。参与者均为居住在新西兰、患有中度至重度社交焦虑症的成年人，以利博维茨社交焦虑量表（LSAS）进行测量。主要关注点是 LSAS 分数从基线到第六周的变化。所有分析均采用意向治疗数据：结果：在 126 名随机参与者中，81 人完成了为期六周的随访。第 6 周的保留率为 67.5%。与等待名单延迟治疗组相比，积极治疗组的 LSAS 分数下降幅度明显更大（积极治疗组平均 = -35.7 [SD = 24.0]；等待名单组：平均 = - 2.2 [SD = 13.5]；P 结论：该研究表明，oVR 能够改善患者的生活质量：研究表明，oVRcome可以有效减轻社交焦虑症状，提供了一种可行的自我指导治疗方案：试验登记：ClinicalTrials.gov ID NCT05576259。

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引用次数: 0

Co-morbid cannabis use disorder and chronotype are associated with mood symptom onset in people with bipolar disorder 共病大麻使用障碍和慢性型与双相情感障碍患者的情绪症状发作有关。

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2024-11-04 DOI: 10.1016/j.jpsychires.2024.11.007

Alannah Miranda , Breanna M. Holloway , William Perry , Arpi Minassian , Michael McCarthy

Comorbid cannabis use disorder (CUD) is disproportionately high in people with bipolar disorder (BD) and has been associated with worsening of BD symptoms. However, many people with BD report regularly using cannabis to ameliorate symptoms, including sleep disturbances. Sleep and circadian rhythm disturbances are hallmark features of BD that often precede the onset of mood symptoms. Genetic studies indicate that circadian disruption may predispose individuals towards both problematic cannabis use and BD, rather than cannabis use directly impacting BD symptoms. To further disentangle these hypotheses, we aimed to investigate the relationship between chronotype, cannabis use disorder (CUD) and BD mood symptoms. Data from 212 participants with BD I from the Pharmacogenomics of Bipolar Disorder study dataset were analyzed for this study. Participants were stratified by those diagnosed with co-morbid CUD and BD symptom variables, including the mean number of mood episodes per year and age of mood symptom onset for both depression and mania symptoms. The Basic Language Morningness scale (BALM) was used to assess chronotype. There was no interaction between morningness levels and CUD on BD symptoms, however both lower morningness and CUD were independently associated with earlier age of mood symptom onset. However, patients who reported initiating cannabis use post mood symptom onset had an earlier mood symptom age of onset compared to those who reported initiating cannabis use prior to mood symptom onset. These findings could provide further evidence that circadian rhythm disruption could be an underlying factor that predisposes individuals toward both CUD and BD.

双相情感障碍（BD）患者合并大麻使用障碍（CUD）的比例很高，并且与双相情感障碍症状的恶化有关。然而，许多躁郁症患者表示经常使用大麻来缓解症状，包括睡眠障碍。睡眠和昼夜节律紊乱是躁狂症的标志性特征，往往先于情绪症状出现。遗传学研究表明，昼夜节律紊乱可能使患者容易出现使用大麻和 BD 问题，而不是使用大麻直接影响 BD 症状。为了进一步区分这些假设，我们旨在研究时型、大麻使用障碍（CUD）和 BD 情绪症状之间的关系。本研究分析了双相情感障碍药物基因组学研究数据集中 212 名患有双相情感障碍 I 的参与者的数据。研究人员根据那些被诊断为合并有 CUD 和 BD 症状变量的患者进行了分层，这些变量包括每年情绪发作的平均次数以及抑郁和躁狂情绪症状的发病年龄。基本语言晨醒量表（BALM）用于评估时型。晨起水平和 CUD 对 BD 症状没有交互作用，但晨起水平较低和 CUD 均与情绪症状发病年龄较早独立相关。不过，与那些报告在情绪症状出现前开始使用大麻的患者相比，报告在情绪症状出现后开始使用大麻的患者的情绪症状发病年龄较早。这些发现进一步证明，昼夜节律紊乱可能是导致 CUD 和 BD 的潜在因素。

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引用次数: 0

Unilateral and bilateral theta burst stimulation for treatment-resistant depression: Follow up on a naturalistic observation study 单侧和双侧θ脉冲刺激治疗耐药抑郁症：自然观察研究的后续研究。

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2024-11-01 DOI: 10.1016/j.jpsychires.2024.10.031

Mariam Elnazali , Ashan Veerakumar , Mervin Blair , Emily L. Pearce , Noah Kim , Sreya Sebastian , Jonathan B. Santo , Yuri E. Rybak , Amer M. Burhan

Objectives

Theta burst stimulation (TBS) is a novel and faster modality of transcranial magnetic stimulation, which is showing promise as a treatment-resistant depression (TRD) treatment. Though TBS can be applied unilaterally or bilaterally, few studies have compared the effectiveness of both approaches in a naturalistic clinical sample. In this retrospective chart review, we aimed to: (1) replicate previous bilateral sequential TBS effectiveness in a larger cohort of patients at a single centre, (2) present treatment outcome data between unilateral and bilateral TBS approaches, (3) investigate baseline factors associated with our observed outcomes, and (4) examine the sustainability of response, with follow-up data up to 6 months from patients.

Methods

We included 161 patients who received TBS (unilateral: n = 64 (40%), 45.55 ± 14.25 years old, 55% females; bilateral: n = 97 (60%), 47.67 ± 15.11 years old, 58% females).

Results

Firstly, we observed 47% response and 34% remission in the bilateral group, replicating findings from a smaller naturalistic study from our group; patients receiving unilateral TBS displayed 36% response and 26% remission, with no significant differences found between unilateral and bilateral TBS in remission and response rates. Secondly, bilaterally stimulated patients needed fewer treatments than those stimulated unilaterally (27 vs 29 on average respectively, t [159] = 3.31, p = .001), and had significantly lower anxiety symptoms post treatment (GAD-7) relative to patients receiving unilateral stimulation, F (1,148) = 3.95, p = .049. Thirdly, no baseline factors were found to predict treatment outcomes. Lastly, after six months, 69% of patients who met the response criteria did not require additional treatment or a change in medication.

Conclusions

Our findings support the efficacy and tolerability of TBS in TRD and indicate that bilateral TBS may have a superior anxiolytic effect and offer a slightly faster time to response.

目的：Theta 脉冲串刺激（TBS）是一种新颖、快速的经颅磁刺激方式，在治疗耐药抑郁症（TRD）方面前景看好。虽然 TBS 可单侧或双侧使用，但很少有研究在自然临床样本中比较这两种方法的有效性。在这项回顾性病历审查中，我们旨在(1）在一个中心的更大患者群中复制之前的双侧顺序 TBS 的有效性；（2）提供单侧和双侧 TBS 方法的治疗结果数据；（3）调查与我们观察到的结果相关的基线因素；以及（4）利用患者长达 6 个月的随访数据检查反应的持续性：我们纳入了 161 名接受 TBS 治疗的患者（单侧：n = 64（40%），45.55 ± 14.25 岁，55% 为女性；双侧：n = 97（60%），47.67 ± 15.11 岁，58% 为女性）：首先，我们观察到双侧组的反应率为 47%，缓解率为 34%，这与我们小组的一项规模较小的自然研究结果相同；接受单侧 TBS 的患者反应率为 36%，缓解率为 26%，单侧和双侧 TBS 在缓解率和反应率方面没有显著差异。其次，与单侧刺激患者相比，双侧刺激患者所需的治疗次数更少（分别为平均 27 次和 29 次，t [159] = 3.31，p = .001），治疗后的焦虑症状（GAD-7）也明显低于单侧刺激患者，F (1,148) = 3.95，p = .049。第三，没有发现任何基线因素可以预测治疗结果。最后，6 个月后，69% 符合反应标准的患者不需要额外治疗或更换药物：我们的研究结果支持TBS对TRD的疗效和耐受性，并表明双侧TBS可能具有更优越的抗焦虑效果，且反应时间稍快。

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引用次数: 0

Physical activity and heart rate in PTSD inpatients: Moderation by custody of a service dog 创伤后应激障碍住院患者的体育活动和心率：饲养服务犬的调节作用

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2024-10-30 DOI: 10.1016/j.jpsychires.2024.10.017

Steven H. Woodward , Andrea L. Jamison , Sasha Gala , Diana Villasenor , Gisselle Tamayo , Melissa Puckett

Posttraumatic stress disorder is associated with autonomic hyperarousal often shown to involve elevated resting heart rate and, simultaneously if somewhat paradoxically, reduced physical activity. Both are risk factors for cardiovascular disease and so may contribute to its elevated prevalence in persons with this diagnosis. Epidemiological studies have observed dog owners to exhibit lower rates of cardiovascular disease. Non-randomized between-group studies have found service dog companionship to be associated with increased physical activity and with lower resting heart rate. A challenge to research in this area is its vulnerability to selection biases in group assignment which could lead to over-estimation of advantages or disadvantages associated with pet or service dog contact and companionship. The current study executed a within-subjects design investigating physical activity and heart rate in a sample of U.S. military Veterans engaged in residential treatment for PTSD and a concurrent service animal training intervention. A mean of 37 days of continuously-recorded day-time physical activity and heart rate were obtained from 45 participants. On days when they had custody of a familiar service-dog-in-training, participants exhibited increased physical activity accompanied by a small reduction in concurrent, activity-adjusted heart rate. Though observed in a specialized context, these short-term findings align with prior observations of lowered risk of cardiovascular disease in association with pet dog ownership. Extended longitudinal designs will be necessary to determine whether such short-term effects truly mediate lowered long-term risk.

创伤后应激障碍与自律神经过度亢奋有关，通常表现为静息心率升高，同时体力活动减少，虽然这有点自相矛盾。这两者都是心血管疾病的危险因素，因此可能会导致这种疾病在患者中的发病率升高。流行病学研究发现，养狗者的心血管疾病发病率较低。非随机组间研究发现，陪伴服务犬与增加体育锻炼和降低静息心率有关。该领域的研究面临的一个挑战是在分组分配时容易出现选择偏差，这可能会导致过高估计与宠物或服务犬接触和陪伴相关的优势或劣势。目前的研究采用了主体内设计，调查了参与创伤后应激障碍住院治疗的美国退伍军人样本的体力活动和心率，并同时进行了服务型动物训练干预。研究人员从 45 名参与者那里获得了平均 37 天的日间连续体力活动和心率记录。在有熟悉的受训服务犬看护的日子里，参与者的体力活动有所增加，同时活动调整后的心率也略有下降。虽然是在特殊情况下观察到的，但这些短期发现与之前观察到的养宠物狗会降低心血管疾病风险的结果一致。要想确定这种短期效应是否真正介导了长期风险的降低，有必要进行扩展的纵向设计。

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引用次数: 0

The association between systemic lupus erythematosus (SLE) and early psychiatric background 系统性红斑狼疮（SLE）与早期精神病背景之间的关联。

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2024-10-30 DOI: 10.1016/j.jpsychires.2024.10.029

Uri Blasbalg , Paz Toren

Background

The etiology of Systemic Lupus Erythematosus (SLE) remains elusive.

Research has established links between SLE and various mental health issues, including associations with psychiatric illness, unique symptomatology in SLE, a relationship between stress and disease exacerbation, and improvement in SLE patients after psychiatric and psychological treatment. However, the hypothesis that psychiatric conditions might precede SLE onset by long periods has not been empirically established. This study aims to address this gap.

Methods

This matched cohort study conducted a retrospective analysis using the electronic database of Clalit Health Services (CHS), Israel's largest HMO, comparing 2786 individuals diagnosed with SLE with 8358 non-SLE matched controls.

Results

Two logistic regression analysis tests revealed significant associations between SLE diagnosis and prior psychiatric conditions.

the first (p < 0.001) showed a 120% higher likelihood of psychiatric history among those diagnosed at least 10 years later with SLE compared to controls, and the second (p = 0.008) showed a 61% greater likelihood of a psychiatric history among those diagnosed at least 15 years with SLE. Investigation into the association between specific psychiatric indices and the later development of SLE found significant correlations between an SLE diagnosis and four psychiatric indices 10 years prior: dispensing of antipsychotics, anxiolytics, hypnotics, and sedatives; dispensing of antidepressants, psychostimulants, ADHD agents, and nootropics; diagnosis of mood disorders; and phobic and anxiety disorders.

Conclusions

The increased probability of pre-existing mental health issues preceding SLE onset by extended durations suggests a potential etiological role in SLE development.

背景：系统性红斑狼疮（SLE）的病因仍然难以捉摸。研究已经证实系统性红斑狼疮与各种心理健康问题之间存在联系，包括与精神疾病的关联、系统性红斑狼疮的独特症状、压力与疾病加重之间的关系，以及系统性红斑狼疮患者在接受精神和心理治疗后病情的改善。然而，关于精神疾病可能早于系统性红斑狼疮发病很长时间的假设尚未得到实证证实。本研究旨在填补这一空白：这项配对队列研究使用以色列最大的 HMO 组织 Clalit Health Services (CHS) 的电子数据库进行了一项回顾性分析，将 2786 名被诊断患有系统性红斑狼疮的患者与 8358 名非系统性红斑狼疮配对对照进行了比较：结果：两个逻辑回归分析测试显示，系统性红斑狼疮诊断与既往精神状况之间存在显著关联：在系统性红斑狼疮发病前存在精神健康问题的概率增加，且持续时间延长，这表明精神健康问题在系统性红斑狼疮的发病过程中起着潜在的致病作用。

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引用次数: 0

Corrigendum to “The identification and measurement of postpartum anxiety in England: A Delphi survey” [J. Psychiatr. Res. 168 (2023) 381–391] 英格兰产后焦虑的识别与测量：德尔菲调查"[J. Psychiatr. Res. 168 (2023) 381-391] 更正

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2024-10-28 DOI: 10.1016/j.jpsychires.2024.10.027

Semra Worrall , Elizabeth J. Harris , Sergio A. Silverio , Victoria Fallon

引用次数: 0

Effect of combined Tai Chi and repetitive transcranial magnetic stimulation for sleep disturbance in older adults: A randomized controlled trial 太极拳与重复经颅磁刺激相结合对老年人睡眠障碍的影响：随机对照试验

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2024-10-26 DOI: 10.1016/j.jpsychires.2024.10.025

Jiali He , Sunny H.W. Chan , Raymond C.K. Chung , Hector W.H. Tsang

Background and aims

Novel approaches to improve sleep disturbance in older adults are needed. Our study comprises a pioneering attempt to test the efficacy of Tai Chi (TC) combined with repetitive transcranial magnetic stimulation (rTMS) in improving sleep disturbance in older adults. The influence of baseline depressive symptoms was tested in a subset of the sample.

Method

In the randomized controlled trial, 152 participants were each allocated to one of the following groups: (1) TC plus active rTMS (n = 38), (2) TC plus sham rTMS (n = 38), (3) TC alone (n = 38), and (4) low-intensity physical exercise (PE) control group (n = 38). Four-week interventions were conducted for each group. The outcomes included insomnia severity, actigraphy-assessed and self-reported sleep parameters, mood states, and quality of life. Assessments were carried out at baseline (T0), post-intervention (T1), and 3-month follow-up (T2).

Results

Of the 152 randomized participants, the mean (SD) age was 67.68 (4.98) years, with 112 female (73.68%). The findings revealed that TC plus active rTMS induced a significant reduction in actigraphy-assessed sleep onset latency compared to TC plus sham rTMS at T1 and T2. In the subsample without depressive symptoms, the combination treatment exhibited a greater benefit in actigraphy-assessed sleep efficiency and wake time after sleep onset compared to both variables in the PE group and in the sham comparator group at T1, respectively. The other subsample with depressive symptoms showed the improvements with TC plus active rTMS, TC plus sham rTMS, and TC alone differed significantly from PE at T1 and T2.

Conclusions

This study has demonstrated the positive effect of TC combined with rTMS on sleep disturbance in older adults. Specific sample characteristics should be considered when applying TC, either alone or combined with rTMS.

背景和目的：改善老年人睡眠障碍需要新的方法。我们的研究是一项开创性的尝试，旨在测试太极拳（TC）与重复经颅磁刺激（rTMS）相结合对改善老年人睡眠障碍的疗效。我们还在部分样本中测试了基线抑郁症状的影响：在随机对照试验中，152 名参与者被分配到以下几组中的一组：（1）经颅磁刺激加主动经颅磁刺激组（38 人）；（2）经颅磁刺激加假经颅磁刺激组（38 人）；（3）单独经颅磁刺激组（38 人）；（4）低强度体育锻炼（PE）对照组（38 人）。每组进行为期四周的干预。研究结果包括失眠严重程度、动图评估和自我报告的睡眠参数、情绪状态和生活质量。评估分别在基线（T0）、干预后（T1）和 3 个月随访（T2）时进行：在 152 名随机参与者中，平均（标清）年龄为 67.68（4.98）岁，女性 112 人（73.68%）。研究结果显示，与TC加假经颅磁刺激相比，在T1和T2阶段，TC加活性经颅磁刺激能显著降低动觉测定的睡眠开始潜伏期。在无抑郁症状的子样本中，联合疗法分别在T1的动觉计评估睡眠效率和睡眠开始后的唤醒时间方面比PE组和假参照组的两个变量都有更大的优势。另一个有抑郁症状的子样本显示，在T1和T2，TC加活性经颅磁刺激、TC加假经颅磁刺激和单独使用TC的改善效果与PE有显著差异：本研究证明了经颅磁刺激联合经颅磁刺激对老年人睡眠障碍的积极影响。在单独应用TC或与经颅磁刺激联合应用时，应考虑特定的样本特征。

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引用次数: 0

Maternal gut-microbiota impacts the influence of intrauterine environmental stressors on the modulation of human cognitive development and behavior 母体肠道微生物群影响宫内环境压力因素对人类认知发展和行为的调节。

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2024-10-24 DOI: 10.1016/j.jpsychires.2024.10.028

Oluwatayo Israel Olasunkanmi , John Aremu , Ma-Li Wong , Julio Licinio , Peng Zheng

This review examines the longstanding debate of nature and intrauterine environmental challenges that shapes human development and behavior, with a special focus on the influence of maternal prenatal gut microbes. Recent research has revealed the critical role of the gut microbiome in human neurodevelopment, and evidence suggest that maternal microbiota can impact fetal gene and microenvironment composition, as well as immunophysiology and neurochemical responses. Furthermore, intrauterine neuroepigenetic regulation may be influenced by maternal microbiota, capable of having long-lasting effects on offspring behavior and cognition. By examining the complex relationship between maternal prenatal gut microbes and human development, this review highlights the importance of early-life environmental factors in shaping neurodevelopment and cognition.

这篇综述探讨了长期以来关于自然界和宫内环境挑战对人类发育和行为的影响的争论，并特别关注母体产前肠道微生物的影响。最近的研究揭示了肠道微生物群在人类神经发育中的关键作用，有证据表明母体微生物群会影响胎儿的基因和微环境组成，以及免疫生理学和神经化学反应。此外，胎儿宫内的神经表观遗传调控可能会受到母体微生物群的影响，从而对后代的行为和认知产生持久的影响。通过研究母体产前肠道微生物与人类发育之间的复杂关系，本综述强调了生命早期环境因素对塑造神经发育和认知的重要性。

引用次数: 0

Exploring accelerated aging as a target of bipolar disorder treatment: A systematic review 将加速衰老作为躁郁症治疗目标的探索：系统综述。

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2024-10-23 DOI: 10.1016/j.jpsychires.2024.10.026

Alan C. Courtes , Rohit Jha , Natasha Topolski , Jair C. Soares , Tatiana Barichello , Gabriel R. Fries

Bipolar disorder (BD) has been linked to accelerated aging processes, with many studies suggesting that drugs used to treat BD may modulate pathways related to aging. This systematic review aimed to determine whether FDA-approved pharmacotherapies for BD have reported effects on aging biomarkers across clinical and preclinical studies. We conducted searches in PubMed and PsychINFO and followed PRISMA guidelines. Out of 6400 records identified, 19 studies met the inclusion criteria. Most preclinical studies tested the effects of BD drugs, especially lithium, on lifespan and telomere biology in cell and animal models. Clinical studies predominantly focused on lithium, evaluating aging markers like telomere length, telomerase, mitochondrial DNA copy number, and epigenetic age acceleration in individuals with BD. Findings indicate that chronic lithium treatment is associated with modulatory effects on aging biomarkers, particularly increased telomere length and telomerase activity. Conversely, some negative results were also reported. Limited evidence suggests potential aging-modulating properties of other mood stabilizers like valproic acid and lamotrigine, evidencing that further investigation is required. Despite variability across studies, the overall findings support the notion that pharmacotherapies used in BD present many effects of aging biomarkers. However, the field is still developing, with a clear emphasis on lithium and a lack of standardized methods to evaluate aging biomarkers in clinical samples. Further research exploring the anti-accelerated aging effects of BD drugs beyond lithium, their mechanisms of action, and potential synergistic effects is warranted.

躁郁症（BD）与加速衰老过程有关，许多研究表明，用于治疗躁郁症的药物可能会调节与衰老有关的途径。本系统性综述旨在确定FDA批准的治疗躁郁症的药物疗法在临床和临床前研究中是否对衰老生物标志物有影响。我们在 PubMed 和 PsychINFO 中进行了检索，并遵循了 PRISMA 指南。在找到的 6400 条记录中，有 19 项研究符合纳入标准。大多数临床前研究测试了 BD 药物（尤其是锂）在细胞和动物模型中对寿命和端粒生物学的影响。临床研究主要集中于锂，评估端粒长度、端粒酶、线粒体 DNA 拷贝数等衰老标志物，以及 BD 患者的表观遗传年龄加速。研究结果表明，长期锂治疗对衰老生物标志物有调节作用，尤其是端粒长度和端粒酶活性的增加。相反，也有一些负面结果的报道。有限的证据表明，丙戊酸和拉莫三嗪等其他情绪稳定剂也具有潜在的衰老调节作用，这证明还需要进一步的研究。尽管各项研究之间存在差异，但总体研究结果支持这样一种观点，即用于 BD 的药物疗法会对衰老生物标志物产生多种影响。然而，这一领域仍在发展之中，其重点显然是锂，而且缺乏评估临床样本中衰老生物标志物的标准化方法。有必要进一步研究锂以外的 BD 药物的抗加速衰老作用、作用机制以及潜在的协同效应。

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引用次数: 0