Neuropsychiatric Disease and Treatment最新文献

Background: Adolescent group may be prone to a variety of behavioral disorders, one of which is nonsuicidal self-injury (NSSI), NSSI intervention is limited for its unknown mechanism, so this study aimed to explore the factors associated with and pathological mechanism underlying NSSI from the perspective of family dysfunction, alexithymia, circRNA_103636 in a sample of Chinese adolescents.

Methods: A total of 200 MDD adolescents with NSSI and 200 healthy controls were enrolled via a convenient sampling method in clinical settings. The Family APGAR Index (APGAR), Toronto Alexithymia Scale (TAS-20), and Adolescent Nonsuicidal Self-injury Assessment Questionnaire (ANSSIAQ) were used for mental assessment of the study group and control group participants. Real-time quantitative reverse transcription PCR (qRT-PCR) was utilized to detect circRNA_103636 expression in peripheral blood mononuclear cells (PBMCs).

Results: There were significant between-group differences of 134 patients (67%) in the study group and 42 patients in the control group (21%) with moderate or severe family dysfunction (P<0.01). The APGAR score was lower, and the difficulty identifying feeling (DIF), difficulty describing feeling (DDF) and externally oriented thinking (EOT) scores of the TAS-20 and ΔCt value of circRNA_103636 were greater in the study group than in the control group. NSSI behavior and NSSI function were negatively correlated with the APGAR score and positively correlated with DIF, DDF, and the EOT of TAS-20 and the ΔCt value of circRNA_103636. Multiple regression analysis confirmed that EOT, circRNA_103636 expression, and APGAR were predictors of ANSSIAQ, which could explain 40.5% of the variance. Similarly, the alexithymia and circRNA_103636 expression mediated the correlation between family dysfunction and NSSI in the study group, and these mediating effects accounted for 27.25% and 23.33%, respectively, of the total effect. Taken together, family dysfunction, alexithymia, and circRNA_103636 expression have predictive effects on NSSI and alexithymia, circRNA_103636 expressions are mediators between family dysfunction and NSSI in Chinese adolescent.

Conclusion: Here, we established a new model for NSSI in which exposure to family dysfunction could induce pathological process by modulating personality traits and epigenetic regulators.

Background: Depression is common among patients with coronary atherosclerotic heart disease and is a prevalent mental health issue, particularly among those with cardiovascular diseases. Depression is commonly associated with elevated blood glucose and lipid levels. The triglyceride-glucose index is a novel indicator reflecting insulin resistance, which has been proven in numerous studies to be associated with cardiovascular diseases.

Purpose: Study on the impact of the triglyceride-glucose index (TyG index) on the development of depression in patients with coronary atherosclerotic heart disease (CHD).

Patients and methods: Using the Patient Health Questionnaire-9 (PHQ-9), 197 CHD patients were classified into a non-depressed group (n = 44, PHQ-9 < 5) and a depressed group (n = 153, PHQ-9 ≥ 5). Fasting blood glucose (GLU), HDL, total cholesterol (TC), LDL, triglycerides (TG), and TyG index were compared between groups. Depression risk factors were identified via logistic regression, and the predictive value of TyG index was evaluated using ROC analysis.

Results: In depressed patients, TyG index, TG, TC, LDL, and GLU were significantly higher, while HDL was lower than in the non-depressed group (p < 0.05). Logistic regression identified TyG index, LDL, GLU, TG, TC, HDL, female sex, smoking, alcohol consumption, and older age as independent risk factors for depression in CHD patients (p < 0.05). ROC analysis showed the TyG index had an AUC of 0.76 (95% CI 0.687-0.829, p < 0.001) for predicting depression, with a cutoff of 1.613, sensitivity of 45.1%, and specificity of 97.7%. Endpoint events were more frequent in the depression group (χ² = 8.015, p = 0.005).

Conclusion: The TyG index is an independent risk factor for depression in patients with CHD, indicating a significant predictive value. Depressed patients have a higher rate of readmission, and managing depression effectively contributes to better prognosis.

Shared decision-making (SDM) has been practiced fairly frequently in general medicine, but less so in mental disorders, especially in closed psychiatric wards, and its positive predictor has recently been recognized in the field of mental health. Studies have shown that patients with severe mental disorders want a say in their care and their desire to participate in clinical decision-making is even higher than those treated by general medical services. This review aims to explore the research progress of SDM for patients with schizophrenia with anxiety in a collectivist culture (such as Chinese culture) and to provide a reference for the implementation of SDM in closed psychiatric wards.