Journal of psychiatric research最新文献_第4页

Examining the associations between laxative use, substance use, depressive symptoms, and obsessions and compulsions in adults with an eating disorder 检查通便药使用、物质使用、抑郁症状以及患有饮食障碍的成年人的强迫和强迫之间的关系。

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2025-02-01 DOI: 10.1016/j.jpsychires.2024.12.043

Brad A. MacNeil, Thomas Gorman, Jason Maier

This study examined laxative and substance use in adults with an eating disorder, and the association with depression, compulsions, and obsessions. A retrospective chart review of 182 women who had a formal diagnosis of an eating disorder and were receiving specialized outpatient treatment was conducted. The chart review included questionnaires completed at intake assessment, including a demographic survey with questions asking about laxative use, substance use, and the types of substances used. Adults also reported their levels of depression, obsessions and compulsions on psychometric questionnaires. Overall, 31.3% of adults with an eating disorder endorsed engagement in laxative use. Substance use was reported by 34.6% of adults with alcohol (36%) and over the counter medications (39%) being the most endorsed substances. Engagement in laxative use and substance use did not differ across the eating disorder diagnoses of anorexia nervosa (AN), bulimia nervosa (BN) or other specified feeding or eating disorder (OSFED). Engagement in substance use was not associated with adults’ symptoms of depression, obsessions, or compulsions. Compulsions were found to be a significant predictor of engagement in laxative use. Variables associated with engagement in laxative use may help to inform the development of novel approaches for addressing these behaviors in adults with an eating disorder. More work is needed to better understand the complex interplay of these behaviors.

本研究调查了患有饮食失调的成年人的泻药和药物使用情况，以及与抑郁、强迫和强迫症的关系。对182名正式诊断为饮食失调并接受专门门诊治疗的妇女进行了回顾性图表回顾。图表回顾包括在摄入评估时完成的问卷调查，包括关于泻药使用、物质使用和使用物质类型的人口调查。成年人还在心理测量问卷中报告了他们的抑郁、强迫症和强迫症的程度。总体而言，31.3%患有饮食失调的成年人赞同使用泻药。34.6%的成年人报告使用物质，酒精（36%）和非处方药物（39%）是最受认可的物质。在神经性厌食症（AN）、神经性贪食症（BN）或其他特定的进食障碍（OSFED）的饮食障碍诊断中，泻药使用和物质使用的参与没有差异。参与药物使用与成年人的抑郁、强迫或强迫症状无关。强迫性行为被发现是参与泻药使用的重要预测因子。与通便药使用相关的变量可能有助于为解决成人饮食失调患者这些行为的新方法的发展提供信息。为了更好地理解这些行为之间复杂的相互作用，还需要做更多的工作。

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引用次数: 0

Investigating the impact of omega-3 fatty acids on oxidative stress and pro-inflammatory cytokine release in iPSC-derived forebrain cortical neurons from ADHD patients 研究omega-3脂肪酸对多动症患者ipsc来源的前脑皮质神经元氧化应激和促炎细胞因子释放的影响。

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2025-02-01 DOI: 10.1016/j.jpsychires.2025.01.020

Natalie M. Walter , Cristine M. Yde Ohki , Lukasz Smigielski , Susanne Walitza , Edna Grünblatt

引用次数: 0

The effects of a sleep intervention in the early COVID-19 pandemic on insomnia and depressive symptoms: Results of a randomized controlled pilot study

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2025-02-01 DOI: 10.1016/j.jpsychires.2025.01.011

Raquel A. Osorno , Maryam Ahmadi , Kathleen P. O'Hora , Natalie L. Solomon , Mateo Lopez , Allison B. Morehouse , Jane P. Kim , Rachel Manber , Andrea N. Goldstein-Piekarski

The COVID-19 Pandemic increased the prevalence and severity of insomnia and depression symptoms. The effects of an insomnia intervention on future insomnia and depression symptoms delivered during an ongoing stressor, which may have precipitated the insomnia symptoms, is unknown. We conducted a two-arm randomized controlled pilot study to evaluate whether an insomnia intervention would improve the trajectory of insomnia and depression symptoms in the context of a global pandemic. Forty-nine individuals with clinically significant insomnia symptoms that emerged after the start of the COVID-19 Pandemic were randomized to one of two groups: one group received four sessions of Cognitive Behavioral Therapy for Insomnia (CBT-I) over five weeks via telehealth, and the other was assigned to a 28-week waitlist control group. Participants completed assessments of insomnia and depressive symptom severity at baseline (week 0) and at weeks 1–6, 12, and 28. Linear mixed-effects models were used to evaluate treatment efficacy. The MacArthur model was used to test whether improvement in insomnia symptoms mediated subsequent improvement in mood. The CBT-I group showed improved trajectories of insomnia (b = -1.03, p < 0.005, 95% CI [-1.53, −0.53]) and depressive symptoms (b = −0.47, p = 0.007, [-0.80, −0.13]) across the 28 weeks compared to the control group. The rate of improvement of insomnia symptoms during treatment mediated the subsequent improvement in depressive symptom severity following treatment (b = 2.10, p = 0.024, [0.30, 3.90]). Although the sample size was small, these results underscore the potential CBT-I in the context of an ongoing stressor to not only alleviate insomnia symptoms, but also improve depressive symptoms.

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引用次数: 0

Potential metabolic sequelae to the terrorist attack of October 7th, 2023

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2025-02-01 DOI: 10.1016/j.jpsychires.2025.01.033

Lawrence Maayan , Eyal Kalanthroff , Ezra Cohen , Yuval Neria

Objective/hypothesis

Evaluate cardiometabolic risk as a potential sequel to a mass terrorist attack using October 7th, 2023 as a focus.

Methods

Narrative review surveying PubMed, PsycNet, UN and Council on Foreign Relations websites on.

1. PTSD following terrorism, rocket attacks and conflict related sexual violence.

2. The relationship between cardiometabolic illness and PTSD.

3. Humoral, genetic and epigenetic mechanisms relating cardiometabolic risk, inflammation and PTSD.

4. Treatments for PTSD and associated cardiometabolic risk factors and their effectiveness.

Findings

Cardiometabolic sequelae occur after trauma. This is most pronounced when trauma, sexual or violence related, occurs during childhood. The risk of cardiometabolic sequelae increases with PTSD diagnosis in adults. Inflammation as well as genes related to inflammatory function (e.g. FKBP5, AHRR, NR3C1) impact vulnerability to PTSD, response to treatment and cardiometabolic outcomes. Treatments for PTSD appear somewhat more effective at lowering cardiometabolic risk in civilian, rather than military populations. There is little published research on directly treating cardiometabolic sequelae of PTSD.

Conclusions

Israelis, particularly those with exposure to the terror events of October 7, 2023 should be screened for psychological and metabolic sequelae. This should occur in a primary care setting and be part of observational research to help understand relationships between trauma, metabolic outcomes and their treatment.

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引用次数: 0

Mapping alterations in the local synchrony of the cerebral cortex in Prader Willi syndrome Prader Willi综合征大脑皮层局部同步性的制图改变。

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2025-02-01 DOI: 10.1016/j.jpsychires.2025.01.012

Laura Blanco-Hinojo , Jesus Pujol , Gerard Martínez-Vilavella , Olga Giménez-Palop , Laia Casamitjana , Jesús Cobo , Rocío Pareja , Susanna Esteba-Castillo , Joan Deus , Assumpta Caixàs

Individuals with Prader Willi syndrome (PWS) often exhibit behavioral difficulties characterized by deficient impulse regulation and obsessive-compulsive features resembling those observed in obsessive-compulsive disorder. The genetic configuration of PWS aligns with molecular and neurophysiological findings suggesting dysfunction in the inhibitory gamma-aminobutyric acid (GABA) interneuron system may contribute to its clinical manifestation. In the cerebral cortex, this dysfunction is expressed as desynchronization of local neural activity. We used functional connectivity MRI to examine potential alterations in the local synchrony of the cerebral cortex in PWS. Whole-brain functional connectivity maps were generated using iso-distance average correlation (IDAC) measures in 22 patients with PWS and 22 control participants. Patients with PWS showed reduced local connectivity (weaker synchrony) in frontal areas, including the orbitofrontal cortex, ventral medial and lateral frontal regions, the anterior cingulate cortex, and sensory areas. The presence of obsessive-compulsive symptoms was significantly associated with the degree of functional structure alteration in part of the orbitofrontal and sensory cortices. In addition, abnormally heightened functional connectivity (stronger synchrony) was identified in the posterior cingulate cortex and the bilateral angular gyri, core components of the default mode network, with distance-dependent effects. Our findings of cortical synchrony alterations indicate a degree of overlap with the anatomy of the alterations previously observed in primary obsessive-compulsive disorder, while also suggesting the implication of GABAergic dysfunction in the pathophysiology of the disorder. Our observations may support the rational development of more specific therapeutic strategies in the treatment of behavioral disinhibition characteristic of PWS.

普拉德-威利综合征（PWS）患者通常表现出行为障碍，其特征是冲动调节能力不足，并具有类似于强迫症的强迫特征。PWS的遗传结构与分子和神经生理学研究结果一致，表明抑制性γ-氨基丁酸（GABA）中间神经元系统的功能障碍可能会导致其临床表现。在大脑皮层，这种功能障碍表现为局部神经活动的不同步。我们利用功能连接核磁共振成像检查了 PWS 患者大脑皮层局部同步性的潜在改变。我们使用等距平均相关性（IDAC）测量方法生成了22名PWS患者和22名对照组参与者的全脑功能连接图。PWS患者的额叶区（包括眶额皮层、腹内侧和外侧额叶区、前扣带回皮层和感觉区）显示出局部连接性降低（同步性减弱）。强迫症状的出现与部分眶额皮层和感觉皮层的功能结构改变程度有显著关联。此外，在后扣带回皮层和双侧角回（默认模式网络的核心组成部分）也发现了异常增强的功能连接（更强的同步性），并具有距离依赖效应。我们对皮层同步性改变的研究结果表明，这些改变与之前在原发性强迫症中观察到的解剖学改变有一定程度的重叠，同时也表明 GABA 能功能障碍与强迫症的病理生理学有关。我们的观察结果可能有助于合理开发更具针对性的治疗策略，以治疗 PWS 的行为抑制特征。

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引用次数: 0

Understanding maladaptive daydreaming from the attachment framework: The intertwining roles of parental care, unresolved attachment, depression/anxiety and obsessive-compulsive symptoms 从依恋框架理解不适应白日梦：父母关怀、未解决的依恋、抑郁/焦虑和强迫症状的相互交织作用。

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2025-02-01 DOI: 10.1016/j.jpsychires.2025.01.015

Micol Gemignani , Elisa Mancinelli , Tommaso Manari , Giulia Gagliardini , Giulia Bassi , Ilaria Chirico , Giulia Gizzi , Giulia Landi , Maria Luisa Pistorio , Virginia Pupi , Eleonora Volpato , Tania Moretta , Alessandro Musetti

Maladaptive Daydreaming (MD) is an excessive absorption in vivid fantasies interfering with individuals' daily functioning, which has been associated with adverse psychological outcomes and adult attachment insecurities. However, no study to date has addressed the relationships between MD, parental care, unresolved attachment, and psychological symptoms (depression/anxiety and obsessive-compulsive disorder; OCD) in a sample of young adults. In this study, 1295 young adults (401 males) completed an online survey including the Parental Bonding Instrument, Maladaptive Daydreaming Scale, Adult Unresolved Attachment Questionnaire, and the DSM-5 Level 1 Cross-Cutting Symptom Measure. The results evidenced the differential contribution of maternal and paternal care on individuals' psychological symptoms; whilst higher maternal care was negatively related to OCD symptoms, higher paternal care was negatively linked to depression/anxiety symptoms. A relationship between unresolved attachment, MD and psychopathological symptoms emerged; specifically, MD mediated the relationships between unresolved attachment and depression/anxiety and OCD symptoms. Overall, paternal and maternal care may have distinct roles in predicting individuals’ psychopathological outcomes. In the presence of unresolved attachment, MD may represent a dissociative response that allows individuals to deal with negative experiences through psychopathological symptoms. Understanding the specific pathways that lead to different psychopathological outcomes could have important implications in developing preventive clinical interventions.

不适应白日梦（MD）是一种过度沉迷于生动的幻想而干扰个人日常功能的行为，它与不良的心理结果和成人依恋不安全感有关。然而，迄今为止还没有研究涉及抑郁症、父母照顾、未解决的依恋和心理症状(抑郁/焦虑和强迫症；强迫症)。本研究对1295名年轻成人（401名男性）进行了在线调查，包括父母关系量表、不适应白日梦量表、成人未解决依恋问卷和DSM-5第一级交叉症状量表。结果表明，母亲和父亲的照顾对个体心理症状的贡献存在差异；虽然较高的母亲护理与强迫症症状呈负相关，但较高的父亲护理与抑郁/焦虑症状呈负相关。未解决的依恋、MD与精神病理症状之间存在关系；具体来说，MD介导了未解决的依恋与抑郁/焦虑和强迫症症状之间的关系。总之，父亲和母亲的照顾在预测个体的精神病理结果方面可能有不同的作用。在存在未解决的依恋时，MD可能代表一种分离反应，允许个体通过精神病理症状处理负面经历。了解导致不同精神病理结果的具体途径可能对开发预防性临床干预具有重要意义。

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引用次数: 0

Seasonal changes in mood and behaviors in individuals with attention-deficit/hyperactivity disorder trait

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2025-02-01 DOI: 10.1016/j.jpsychires.2025.01.044

Yuri Jo , Shunsuke Takagi , Masaaki Shimizu , Hidehiko Takahashi , Genichi Sugihara

Background

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder often accompanied by mood disorders such as seasonal affective disorder (SAD), characterized by seasonal mood and behavioral changes. Although a genetic link between ADHD and SAD has been proposed, research on their relationship remains limited.

Methods

An online questionnaire survey was conducted to explore the relationship between ADHD traits and seasonal mood changes. The Adult ADHD Self-Report Scale (ASRS) and the Seasonal Pattern Assessment Questionnaire (SPAQ), measured by the General Seasonality Score (GSS), were used.

Results

From a sample of 3000 participants, a significant correlation was found between ASRS and GSS (r = 0.42, p < 0.001). Potential ADHD subjects had significantly higher GSS scores than non-ADHD subjects (mean 10.2 vs. 6.7, p < 0.001). The prevalence of potential SAD during winter was higher among potential ADHD participants: 8.5% in potential ADHD participants, and 2.0% in non-ADHD participants (p < 0.001). Further analyses indicated that possible ADHD participants experienced significant seasonal changes in body weight, sleep duration, and food preferences. Additional analyses using GSS as a covariate showed that changes in body weight and sleep duration were not solely due to GSS, whereas changes in food preference were significantly associated with GSS.

Conclusion

This study demonstrated that individuals with ADHD traits are more susceptible to seasonal mood variations. Additionally, ADHD traits were significantly associated with seasonal changes in body weight, sleep patterns, and food preferences. These findings underscore the importance of considering seasonal factors in clinical settings to improve the quality of life for individuals with ADHD.

{"title":"Seasonal changes in mood and behaviors in individuals with attention-deficit/hyperactivity disorder trait","authors":"Yuri Jo , Shunsuke Takagi , Masaaki Shimizu , Hidehiko Takahashi , Genichi Sugihara","doi":"10.1016/j.jpsychires.2025.01.044","DOIUrl":"10.1016/j.jpsychires.2025.01.044","url":null,"abstract":"<div><h3>Background</h3><div>Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder often accompanied by mood disorders such as seasonal affective disorder (SAD), characterized by seasonal mood and behavioral changes. Although a genetic link between ADHD and SAD has been proposed, research on their relationship remains limited.</div></div><div><h3>Methods</h3><div>An online questionnaire survey was conducted to explore the relationship between ADHD traits and seasonal mood changes. The Adult ADHD Self-Report Scale (ASRS) and the Seasonal Pattern Assessment Questionnaire (SPAQ), measured by the General Seasonality Score (GSS), were used.</div></div><div><h3>Results</h3><div>From a sample of 3000 participants, a significant correlation was found between ASRS and GSS (r = 0.42, p < 0.001). Potential ADHD subjects had significantly higher GSS scores than non-ADHD subjects (mean 10.2 vs. 6.7, p < 0.001). The prevalence of potential SAD during winter was higher among potential ADHD participants: 8.5% in potential ADHD participants, and 2.0% in non-ADHD participants (p < 0.001). Further analyses indicated that possible ADHD participants experienced significant seasonal changes in body weight, sleep duration, and food preferences. Additional analyses using GSS as a covariate showed that changes in body weight and sleep duration were not solely due to GSS, whereas changes in food preference were significantly associated with GSS.</div></div><div><h3>Conclusion</h3><div>This study demonstrated that individuals with ADHD traits are more susceptible to seasonal mood variations. Additionally, ADHD traits were significantly associated with seasonal changes in body weight, sleep patterns, and food preferences. These findings underscore the importance of considering seasonal factors in clinical settings to improve the quality of life for individuals with ADHD.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"182 ","pages":"Pages 462-468"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The preventive effect of psychological and psychosocial interventions on postpartum depression: An overview of systematic reviews 心理和社会心理干预对产后抑郁症的预防作用：系统综述。

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2025-02-01 DOI: 10.1016/j.jpsychires.2024.11.050

Weijing Qi (齐伟静) , Sha Huang (黄莎) , Jinping Zhao (赵金萍) , Xuefei Cui (崔雪菲) , Ziqi Wei (魏子琪) , Gaiying Cui (崔改英) , Qing Guo (郭清) , Jie Hu (胡洁)

Background

Postpartum depression is a prevalent issue that significantly impacts the mental health of women, placing a substantial burden on individuals, families, and society. With the increasing evidence of postpartum depression prevention, conducting comprehensive assessments becomes essential to facilitate future clinical practices.

Methods

The systematic review and meta-analysis examined psychological and psychosocial interventions to prevent postpartum depression in perinatal women (antenatal and postnatal up to 12 months). In January 2022 and November 2023, nine English- and four Chinese-language databases were searched. Two authors independently carried out literature screening and data extraction. To assess the quality of methodological, reporting, and evidence of the included reviews, the AMSTAR-2 scale, PRISMA statement, and GRADE approach were employed by the two authors.

Results

Twenty-eight eligible reviews were included, with medium-very low methodological quality. These reviews reported on 15 effective preventive interventions in four categories. However, due to inconsistent results across the studies, it was challenging to pinpoint the most beneficial interventions conclusively.

Limitations

Grey literature and unpublished articles were not searched, and the limitation on included reviews may result in biased results. In our narrative summary, data overlap in the original study was not considered. The low quality of the identified reviews further undermines the credibility of the evidence.

Conclusions

The study identified four promising aspects of preventive interventions, namely psychological, educational, support, and maternal-infant interventions. However, to draw more robust and reliable conclusions, future research must focus on higher-quality studies that directly compare the effectiveness of these different interventions.

背景：产后抑郁症是一个普遍存在的问题，严重影响妇女的心理健康，给个人、家庭和社会带来了沉重的负担。随着预防产后抑郁症的证据越来越多，进行全面的评估对于促进未来的临床实践至关重要。方法：系统回顾和荟萃分析研究了围产期妇女（产前和产后12个月）预防产后抑郁症的心理和社会心理干预措施。在2022年1月和2023年11月，检索了9个英文数据库和4个中文数据库。两位作者独立进行文献筛选和数据提取。为了评估纳入综述的方法学、报告和证据的质量，两位作者采用了AMSTAR-2量表、PRISMA声明和GRADE方法。结果：纳入了28篇符合条件的综述，方法学质量中等至极低。这些审查报告了四类15种有效的预防干预措施。然而，由于研究结果不一致，确定最有益的干预措施是具有挑战性的。局限性：未检索灰色文献和未发表的文章，对纳入综述的限制可能导致结果偏倚。在我们的叙述性总结中，没有考虑原始研究中的数据重叠。已确定的评价的低质量进一步破坏了证据的可信度。结论：该研究确定了预防干预的四个有希望的方面，即心理，教育，支持和母婴干预。然而，为了得出更有力和可靠的结论，未来的研究必须集中在更高质量的研究上，直接比较这些不同干预措施的有效性。

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引用次数: 0

Plausible therapeutic effects of melatonin and analogs in the dopamine-associated pathophysiology of bipolar disorder 褪黑素和类似物在双相情感障碍多巴胺相关病理生理中的合理治疗作用。

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2025-02-01 DOI: 10.1016/j.jpsychires.2024.12.046

Laurence S. Pe , Kristine Cate S. Pe , Jiraporn Panmanee , Piyarat Govitrapong , Jenq-Lin Yang , Sujira Mukda

Bipolar disorder (BD) is a significant neuropsychiatric condition characterized by marked psychological mood disturbances. Despite extensive research on the symptomatology of BD, the mechanisms underlying its development and presentation remain unknown. Consequently, potential treatments are limited, and existing medications often cause significant side effects, leading to treatment discontinuation. Dopamine (DA) has been implicated in behavioral regulation, reward systems, and mood, highlighting the importance of the dopaminergic system in BD. Elevated levels of DA and tyrosine hydroxylase are associated with the onset of manic episodes, whereas reduced levels are linked to the depressive phase. Additionally, endogenous melatonin (MEL) levels are considerably lower in patients with BD. When administered as a treatment, exogenous MEL and MEL agonists improve behavioral characteristics and significantly modulate DA-related pathophysiological pathways in BD, with minimal adverse effects achieved through MEL receptor activation. Moreover, MEL and MEL agonists offer neuroprotection by promoting physiological homeostasis during disruption. The aim of this review is to investigate and propose MEL receptors as potential novel therapeutic targets for BD. This review seeks to analyze the role of MEL and its agonists in modulating dopamine-related pathophysiological pathways, improving behavioral outcomes, and providing neuroprotection with minimal side effects.

双相情感障碍（BD）是一种显著的神经精神疾病，其特征是明显的心理情绪障碍。尽管对双相障碍的症状学进行了广泛的研究，但其发展和表现的机制仍不清楚。因此，潜在的治疗方法是有限的，现有的药物往往会引起严重的副作用，导致治疗中断。多巴胺（DA）与行为调节、奖励系统和情绪有关，强调了多巴胺能系统在双相障碍中的重要性。DA和酪氨酸羟化酶水平升高与躁狂发作有关，而水平降低与抑郁期有关。此外，内源性褪黑激素（MEL）水平在双相障碍患者中相当低。当作为一种治疗手段使用时，外源性褪黑激素和MEL激动剂改善了双相障碍患者的行为特征，并显著调节了da相关的病理生理途径，通过MEL受体激活实现的不良反应最小。此外，MEL和MEL激动剂在神经紊乱时通过促进生理稳态提供神经保护。本综述的目的是研究并提出MEL受体作为双相障碍潜在的新治疗靶点。本综述旨在分析MEL及其激动剂在调节多巴胺相关的病理生理途径、改善行为结果和提供最小副作用的神经保护方面的作用。

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引用次数: 0

Imagery rehearsal therapy for the treatment of nightmares in individuals with borderline personality disorder – A pilot study 意象排演疗法治疗边缘型人格障碍患者的噩梦-一项初步研究。

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2025-02-01 DOI: 10.1016/j.jpsychires.2024.12.044

Clara Sayk , Nicole Koch , Janine Stierand , Felix Timpe , Hong-Viet V. Ngo , Ines Wilhelm , Klaus Junghanns

Insomnia and nightmares are present in up to 45 % of individuals with borderline personality disorder (BPD) and can contribute to challenges with emotion regulation, low sleep quality, dream anxiety, increased arousal and self-control. Despite their prevalence, nightmares are usually not addressed in classical BPD treatment. Imagery rehearsal therapy (IRT) is considered first in line treatment for nightmares, however, there are no studies to date that investigate its effects in individuals with BPD. Here we investigated a) whether IRT can be used to treat nightmares in individuals with BPD and b) whether there is an additional benefit of the intervention on symptoms associated with BPD. In a between-subjects design, 22 individuals with BPD completed eight sessions of group-IRT as an add-on to their inpatient treatment and were compared to 22 gender and age matched control participants regarding nightmares, trauma, depression and anxiety symptoms. Nightmare symptoms improved significantly during the intervention as indicated by subjective ratings. Moreover, participants in the IRT group showed a more pronounced decrease in intrusions, hyperarousal and anxiety compared to the control group. This pilot study gives a first glimpse into the feasibility and benefits of imagery rehearsal therapy in individuals with BPD. Our findings suggest that IRT may not only help treat nightmare symptoms but also reduce anxiety and trauma symptoms in BPD. Future studies should include randomized controlled trials of IRT in individuals with BPD with larger sample sizes and polysomnography in both groups.

高达45%的边缘型人格障碍（BPD）患者存在失眠和噩梦，这可能会导致情绪调节方面的挑战、睡眠质量低下、梦境焦虑、觉醒和自我控制能力增强。尽管噩梦很普遍，但在经典的BPD治疗中，噩梦通常不会得到解决。意象排演疗法（IRT）被认为是治疗噩梦的首选疗法，然而，迄今为止还没有研究调查它对BPD患者的影响。在这里，我们调查了a) IRT是否可以用于治疗BPD患者的噩梦，b)干预是否对BPD相关症状有额外的好处。在受试者之间的设计中，22名BPD患者完成了8次小组irt，作为他们住院治疗的补充，并与22名性别和年龄匹配的对照组参与者进行了噩梦、创伤、抑郁和焦虑症状的比较。根据主观评分，噩梦症状在干预期间显著改善。此外，与对照组相比，IRT组的参与者在干扰、过度觉醒和焦虑方面表现出更明显的减少。这项初步研究首次揭示了意象排演疗法在BPD患者中的可行性和益处。我们的研究结果表明，IRT不仅可以帮助治疗噩梦症状，还可以减轻BPD患者的焦虑和创伤症状。未来的研究应该包括在BPD患者中进行IRT的随机对照试验，样本量更大，两组都要进行多导睡眠图检查。

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引用次数: 0