Personalized Medicine in Psychiatry最新文献_第3页

Review on the relationship of asthma and mental disorders 哮喘与精神障碍关系研究进展

Personalized Medicine in Psychiatry

Pub Date : 2025-05-13 DOI: 10.1016/j.pmip.2025.100157

João Freitas , Filipa Novais

Asthma is a complex, chronic condition affecting airway function, often accompanied by wheezing and breathlessness. Recent research has begun to explore the associations between asthma and mental disorders, particularly anxiety and depression. This review focuses on the emerging evidence suggesting a bidirectional relationship, where asthma may exacerbate mental health conditions and vice versa. Several hypotheses may explain these connections, including overlapping inflammatory pathways, altered interoceptive perception, and shared psychosocial stressors. We also explore how asthma phenotypes, different asthma treatment modalities, and breathing patterns may mediate the relationship between asthma and mental disorders such as anxiety and depressive disorders. Additionally, this review presents insights from the field of Psychoneuroimmunology and discusses the potential benefits of non-pharmacological approaches such as mindfulness, yoga, and breathing exercises. Overall, this narrative review emphasizes the need for an interdisciplinary approach to asthma management, stressing the importance of the biopsychosocial model in understanding shared pathogenic mechanisms across disorders involving psychoneuroimmunological pathways. Through this perspective, one can better understand the connections between respiratory and psychological health. This review also attempts to reveal some of the disagreements in the field, showing that more research is required to understand the risk profile that asthmatics carry when it comes to mental disorders.

哮喘是一种影响气道功能的复杂慢性疾病，常伴有喘息和呼吸困难。最近的研究已经开始探索哮喘和精神障碍之间的联系，特别是焦虑和抑郁。本综述的重点是新出现的证据表明双向关系，其中哮喘可能加剧精神健康状况，反之亦然。有几种假说可以解释这些联系，包括重叠的炎症通路、改变的内感受性知觉和共同的社会心理压力源。我们还探讨了哮喘表型、不同的哮喘治疗方式和呼吸模式如何介导哮喘与精神障碍（如焦虑和抑郁障碍）之间的关系。此外，本综述还介绍了心理神经免疫学领域的见解，并讨论了非药物方法（如正念、瑜伽和呼吸练习）的潜在益处。总的来说，这篇叙述性综述强调了跨学科哮喘管理方法的必要性，强调了生物心理社会模型在理解涉及心理神经免疫途径的疾病的共同致病机制方面的重要性。从这个角度来看，人们可以更好地理解呼吸和心理健康之间的联系。这篇综述也试图揭示该领域的一些分歧，表明需要更多的研究来了解哮喘患者在精神障碍方面的风险。

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引用次数: 0

The relationship between the personality trait locus of control and help-seeking behavior in persons with anxiety or depressive disorders 焦虑或抑郁障碍患者人格特质控制点与求助行为的关系

Personalized Medicine in Psychiatry

Pub Date : 2025-05-12 DOI: 10.1016/j.pmip.2025.100158

Sietske Leijstra , Aartjan T.F. Beekman , Philip Spinhoven , Johanna H.M. Hovenkamp-Hermelink

Background

Help-seeking behavior in patients with psychological disorders may facilitate or hinder access to care. This study aims to determine the relationship between the personality trait locus of control (LOC) and help-seeking among people with anxiety and/or depressive disorders.

Methods

Cross-sectional data were derived from The Netherlands Study of Depression and Anxiety. In 1434 participants with a current depression and/or anxiety disorder help-seeking was measured by the Perceived Need for Care Questionnaire. LOC was measured by the Mastery scale.

Results

A more internal LOC orientation was associated with less help-seeking. In the group that did seek help, a more external LOC orientation was found to be associated with certain types of help, and with more types of help. After adding neuroticism or depressive symptom severity to the regression models, the predictive value of LOC for help-seeking was no longer significant.

Conclusions

This research shows that for people with anxiety and/or depressive disorders LOC orientation was associated with help-seeking. However, this association disappeared after adjusting for depressive symptom severity or neuroticism. As LOC, neuroticism, and depression are correlated and all three concepts are important for understanding patients’ help-seeking behavior, it is worthwhile to further study them in concert in longitudinal designs.

背景心理障碍患者的求助行为可能促进或阻碍获得护理。本研究旨在探讨人格特质控制位点（LOC）与焦虑和/或抑郁障碍患者寻求帮助的关系。方法横断面数据来源于荷兰抑郁与焦虑研究。对1434名目前患有抑郁症和/或焦虑症的参与者进行了护理感知需求问卷调查。LOC由掌握量表测量。结果内部LOC倾向越强，求助倾向越少。在寻求帮助的小组中，更外向的LOC倾向与某些类型的帮助有关，并且与更多类型的帮助有关。在回归模型中加入神经质或抑郁症状严重程度后，LOC对求助的预测价值不再显著。结论本研究表明，对于焦虑和/或抑郁症患者，LOC取向与寻求帮助有关。然而，在调整抑郁症状严重程度或神经质后，这种联系消失了。由于LOC、神经质和抑郁是相关的，这三个概念对理解患者的求助行为都很重要，因此值得在纵向设计中进一步研究它们的协同作用。

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引用次数: 0

Examining the efficacy of antidepressant pharmacotherapy for interpersonal sensitivity in patients with depressive disorders 探讨抗抑郁药物治疗对抑郁症患者人际关系敏感性的疗效

Personalized Medicine in Psychiatry

Pub Date : 2025-05-07 DOI: 10.1016/j.pmip.2025.100153

Cindy Li, Orhan Yilmaz, Evyn M. Peters

Interpersonal sensitivity is a transdiagnostic trait vulnerability factor for several psychiatric conditions, most notably atypical depression. Surprisingly little research attention has been devoted to pharmacotherapy for interpersonal sensitivity. We conducted a literature review of randomized controlled trials conducted over five decades to determine which antidepressant medications have demonstrated efficacy on the Hopkins Symptom Checklist interpersonal sensitivity factors. Our search focused on adult samples with unipolar depressive disorders. Compared to placebo, we found consistent evidence for the superiority of selective serotonin reuptake inhibitors and imipramine, as well as monoamine oxidase inhibitors (mainly phenelzine) specifically for patients with atypical or anxious depression. Mianserin did not appear to be effective in two trials. Phenelzine was superior to imipramine, but only for patients with atypical features, mirroring the trends observed for depression treatment effects in those trials. There was inconsistent evidence for the superiority of selective serotonin reuptake inhibitors over tricyclics (mainly imipramine), but no studies reported the converse. Some trials were underpowered with small sample sizes, or did not adequately report statistics. There was a notable absence of studies with newer antidepressants. Although interpersonal sensitivity clearly responds to serotonergic antidepressants, it is not clear from the existing literature if these are more effective than medications lacking such properties. Future research will need to carefully choose pharmacologic agents with nonoverlapping mechanisms to answer this question.

人际关系敏感性是一种跨诊断性的易感性因素，可导致多种精神疾病，尤其是非典型抑郁症。令人惊讶的是，很少有研究关注药物治疗对人际敏感性的影响。我们对50多年来进行的随机对照试验进行了文献回顾，以确定哪些抗抑郁药物对霍普金斯症状检查表人际敏感因素有效。我们的研究集中在患有单相抑郁症的成人样本上。与安慰剂相比，我们发现有一致的证据表明选择性血清素再摄取抑制剂和丙咪嗪以及单胺氧化酶抑制剂（主要是苯乙胺）特别适用于非典型或焦虑性抑郁症患者。在两项试验中，米安色林似乎没有效果。苯乃津优于丙咪嗪，但仅适用于具有非典型特征的患者，这反映了在这些试验中观察到的抑郁症治疗效果的趋势。选择性血清素再摄取抑制剂优于三环类药物（主要是丙咪嗪）的证据并不一致，但没有研究报道相反的情况。一些试验样本量小，效果不足，或者没有充分报告统计数据。值得注意的是，缺乏对新型抗抑郁药的研究。虽然人际关系敏感性对血清素抗抑郁药有明显的反应，但从现有的文献中还不清楚这些药物是否比缺乏这种特性的药物更有效。未来的研究将需要仔细选择具有非重叠机制的药物来回答这个问题。

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引用次数: 0

A systematic review of potential publication bias in U.S. National Institutes of Health-funded trials of psychological treatments for obsessive-compulsive disorder in adults 美国国立卫生研究院资助的成人强迫症心理治疗试验中潜在出版偏倚的系统回顾

Personalized Medicine in Psychiatry

Pub Date : 2025-04-22 DOI: 10.1016/j.pmip.2025.100154

Samuel D. Spencer , Nicholas C. Borgogna , Tyler Owen , Catherine E. Rast , David A.L. Johnson , Jessica Szu-Chi Cheng , Ace Castillo , Eric A. Storch , Matti Cervin , Steven D. Hollon

Cognitive-behavioral therapy (CBT) with exposure and response prevention is the most empirically supported psychological treatment for obsessive–compulsive disorder (OCD). Healthcare organizations and practice guidelines recommending CBT for OCD typically rely on meta-analyses that usefully aggregate treatment outcome findings. However, a critical methodological aspect of meta-analyses is the potential impact of publication bias— that is, the tendency for significant findings to be published more frequently than non-significant ones, which can inflate overall effect sizes and lead to inaccurate conclusions about treatment efficacy. Identifying unpublished studies is difficult without a complete record of all studies actually conducted. To address this issue, we searched databases of United States National Institutes of Health (NIH) grants between 1980–2018 that funded comparator randomized controlled trials (RCTs) examining the efficacy of psychological treatments for adults with OCD and determined whether identified grants resulted in publications. Results indicated that 100 % of the ten identified grants resulted in publications, suggesting an absence of publication bias in this area of the literature. Quantitative aggregation of findings from the ten identified grants revealed a large effect size (g = 0.74, 95 % CI = [0.48, 0.99)], τ = 0.44). for comparisons between identified psychological treatments and a range of comparator conditions for reducing OCD symptomology measured by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Findings are discussed in the context of meta-science issues and methodological challenges related to publication bias in hopes of improving clinical research methods and intervention development for treatments of OCD.

暴露与反应预防相结合的认知行为疗法（CBT）是治疗强迫症（OCD）最具实证支持的心理疗法。推荐CBT治疗强迫症的医疗机构和实践指南通常依赖于有效汇总治疗结果的荟萃分析。然而，荟萃分析的一个关键方法学方面是发表偏倚的潜在影响——也就是说，重要的发现比不重要的发现发表得更频繁的趋势，这可能会夸大总体效应大小，导致关于治疗功效的结论不准确。如果没有所有实际进行的研究的完整记录，确定未发表的研究是困难的。为了解决这个问题，我们检索了1980年至2018年期间美国国立卫生研究院（NIH）资助的数据库，这些资助的比较随机对照试验（rct）研究了成年强迫症患者心理治疗的疗效，并确定了这些资助是否导致了出版物的发表。结果表明，10个确定的资助中100%都发表了论文，这表明在这一领域的文献中没有发表偏倚。对10个已确定的资助项目的研究结果进行定量汇总，发现效应量很大（g = 0.74, 95% CI = [0.48, 0.99）], τ = 0.44)。通过耶鲁-布朗强迫症量表（Y-BOCS）对已确定的心理治疗方法和一系列减轻强迫症症状的比较条件进行比较。研究结果在与发表偏倚相关的元科学问题和方法学挑战的背景下进行了讨论，以期改善临床研究方法和强迫症治疗的干预开发。

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引用次数: 0

Approaches to mitigate weight gain associated with antipsychotic use 减轻与使用抗精神病药物相关的体重增加的方法

Personalized Medicine in Psychiatry

Pub Date : 2025-04-10 DOI: 10.1016/j.pmip.2025.100151

Faith Tran , Alexaundria Barnes , Rebecca Urbonas , Zina Meriden

Background

Antipsychotics are vital in the management of multiple psychiatric disorders. Weight gain is a common adverse effect that can impact quality of life and long-term adherence to treatment. The goal of this literature review is to explore posited mechanisms for antipsychotic-induced weight gain (AIWG) and review proposed nonpharmacological and pharmacological interventions to mitigate this weight gain.

Methods

An electronic literature search was performed on PubMed to identify full-text, English-language articles that discussed AIWG. Selected articles were published between 2000 and 2024.

Results

Findings from 68 articles were reviewed and discussed. 27 strategies/agents of varying efficacies were identified. Non-pharmacologic interventions exhibit data in being effective against AIWG. Switching to an antipsychotic with a more favorable side-effect profile can be an appropriate option, but it is associated with an increased risk of relapse. Metformin is the most widely accepted and researched adjunctive treatment, followed by liraglutide and samidorphan. Dulaglutide, semaglutide, topiramate, betahistine, amantadine hydrochloride, berberine, probiotics, dietary fiber, nanoparticle formulation, and reboxetine show promising results in the attenuation of AIWG but need further research to understand their efficacy, metabolic effects, and safety. Melatonin, vitamin D, orlistat, modafinil, and naltrexone currently have very little data and have yet to exhibit compelling results. Lorcaserin, rimonabant, and sibutramine have all been removed from the market in the United States and are not recommended.

Conclusion

Data on AIWG is diverse, but scarce. Further research is needed to better understand the pathophysiology of AIWG and explore long-term effectiveness and safety of promising pharmacologic therapies in this vulnerable patient population.

背景：抗精神病药物在治疗多种精神疾病中起着至关重要的作用。体重增加是一种常见的不良反应，可以影响生活质量和长期坚持治疗。本文献综述的目的是探讨抗精神病药物诱导的体重增加（AIWG）的可能机制，并综述建议的非药物和药物干预措施来减轻这种体重增加。方法在PubMed上进行电子文献检索，找出讨论AIWG的全文英文文章。所选文章发表于2000年至2024年之间。结果对68篇文献的研究结果进行了回顾和讨论。确定了27种不同疗效的策略/药物。数据显示，非药物干预措施对AIWG有效。转而使用副作用更小的抗精神病药物可能是一个合适的选择，但它与复发风险增加有关。二甲双胍是最被广泛接受和研究的辅助治疗，其次是利拉鲁肽和萨米多芬。杜拉鲁肽、半马鲁肽、托吡酯、倍他组碱、盐酸金刚烷胺、小檗碱、益生菌、膳食纤维、纳米颗粒制剂和瑞波西汀在AIWG的衰减方面有很好的效果，但还需要进一步的研究来了解它们的有效性、代谢效应和安全性。褪黑素、维生素D、奥利司他、莫达非尼和纳曲酮目前的数据很少，尚未显示出令人信服的结果。洛卡色林、利莫那班和西布曲明都已从美国市场下架，不推荐使用。结论AIWG相关资料多样，但缺乏。需要进一步的研究来更好地了解AIWG的病理生理学，并探索有希望的药物治疗在这一弱势患者群体中的长期有效性和安全性。

{"title":"Approaches to mitigate weight gain associated with antipsychotic use","authors":"Faith Tran , Alexaundria Barnes , Rebecca Urbonas , Zina Meriden","doi":"10.1016/j.pmip.2025.100151","DOIUrl":"10.1016/j.pmip.2025.100151","url":null,"abstract":"<div><h3>Background</h3><div>Antipsychotics are vital in the management of multiple psychiatric disorders. Weight gain is a common adverse effect that can impact quality of life and long-term adherence to treatment. The goal of this literature review is to explore posited mechanisms for antipsychotic-induced weight gain (AIWG) and review proposed nonpharmacological and pharmacological interventions to mitigate this weight gain.</div></div><div><h3>Methods</h3><div>An electronic literature search was performed on PubMed to identify full-text, English-language articles that discussed AIWG. Selected articles were published between 2000 and 2024.</div></div><div><h3>Results</h3><div>Findings from 68 articles were reviewed and discussed. 27 strategies/agents of varying efficacies were identified. Non-pharmacologic interventions exhibit data in being effective against AIWG. Switching to an antipsychotic with a more favorable side-effect profile can be an appropriate option, but it is associated with an increased risk of relapse. Metformin is the most widely accepted and researched adjunctive treatment, followed by liraglutide and samidorphan. Dulaglutide, semaglutide, topiramate, betahistine, amantadine hydrochloride, berberine, probiotics, dietary fiber, nanoparticle formulation, and reboxetine show promising results in the attenuation of AIWG but need further research to understand their efficacy, metabolic effects, and safety. Melatonin, vitamin D, orlistat, modafinil, and naltrexone currently have very little data and have yet to exhibit compelling results. Lorcaserin, rimonabant, and sibutramine have all been removed from the market in the United States and are not recommended.</div></div><div><h3>Conclusion</h3><div>Data on AIWG is diverse, but scarce. Further research is needed to better understand the pathophysiology of AIWG and explore long-term effectiveness and safety of promising pharmacologic therapies in this vulnerable patient population.</div></div>","PeriodicalId":19837,"journal":{"name":"Personalized Medicine in Psychiatry","volume":"51 ","pages":"Article 100151"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Panic disorder is common in medical students: Assessing the prevalence of panic disorder among medical students using the panic disorder screener (PADIS) 惊恐障碍在医学生中很常见：使用惊恐障碍筛查（PADIS）评估惊恐障碍在医学生中的患病率

Personalized Medicine in Psychiatry

Pub Date : 2025-03-27 DOI: 10.1016/j.pmip.2025.100152

Laith Ashour , Lama Al-Mehaisen , Nada Freihat , Qusai Al-Anasweh , Hala Al-Miqdadi , Mohammad Al Khreisha , Osama Alrjoob , Afnan Rababa , Malak Al-Rabe’e , Al-Mo’tasem Bellah Al-Rahamneh , Moutaz Amayrh , Ala’ Al-Doaikat , Hamzeh Hatamleh , Fayez Zedat

This study aims to determine the prevalence of panic disorder among medical students. Using the Panic Disorder Screener (PADIS) Scale for the screening of panic disorder (PD), we conducted a cross-sectional study targeting medical students from 2nd to 6th year at Al-Balqa Applied University, Jordan, with a sample of 361 students. Using convenience sampling method, the questionnaires were disseminated to medical students via social media educational groups and direct contact with the students. To analyze which factors predict PD among medical students, we used a Multiple Firth Logistic regression model, and to check the construct validity of the PADIS scale we used Confirmatory Factor Analysis (CFA), alongside Cronbach’s alpha standardized coefficient for reliability. The scale construct was validated with acceptable CFA fit indices (TLI = 0.996, CFI = 0.999, RMSEA = 0.027, and SRMR = 0.019) and accepted internal consistency (Cronbach’s alpha = 0.733). Interestingly, 140 students reported having recurrent panic attacks (38.8 %). Nevertheless, 103 students (28.5 %) fully satisfied the diagnostic criteria for PD, indicating its high prevalence within this population. The most common method used to overcome the attack was deep breathing or special maneuvers (44 %). According to the regression results, PD was significantly less likely to be present among those who hadn’t experience panic attacks before attending medical school (Odds Ratio (OR) = 0.43; 95 % CI = [0.2–0.91]; P = 0.028), more likely to be in females (OR = 3.12; 95 % CI = [1.53–6.6]; P = 0.002), and significantly more prevalent among students from lower years compared to 6th year students. Interventions should be applied in medical faculties, as PD is not uncommon in this population.

本研究旨在确定惊恐障碍在医学生中的患病率。我们使用恐慌症筛查量表（PADIS）筛查恐慌症（PD），针对约旦巴勒卡应用大学二年级至六年级的医学生开展了一项横断面研究，样本为 361 名学生。研究采用方便抽样法，通过社交媒体教育小组和与学生直接接触的方式向医学生发放问卷。为了分析哪些因素可以预测医学生的肢端麻痹症，我们使用了多元费思逻辑回归模型；为了检验 PADIS 量表的结构效度，我们使用了确认性因子分析（CFA），并使用 Cronbach's alpha 标准化系数来检验其可靠性。量表结构得到了验证，CFA拟合指数（TLI = 0.996、CFI = 0.999、RMSEA = 0.027 和 SRMR = 0.019）和内部一致性（Cronbach's alpha = 0.733）均可接受。有趣的是，有 140 名学生（38.8%）表示曾反复出现恐慌发作。然而，有 103 名学生（28.5%）完全符合恐慌症的诊断标准，这表明恐慌症在这一人群中的发病率很高。最常用的克服发作的方法是深呼吸或特殊动作（44%）。回归结果显示，在就读医学院之前未经历过恐慌症发作的人中，出现恐慌症的几率明显较低（Odds Ratio (OR) = 0.43; 95 % CI = [0.2-0.91]; P = 0.028），女性出现恐慌症的几率更高（OR = 3.12; 95 % CI = [1.53-6.6]; P = 0.002），低年级学生的发病率明显高于六年级学生。应在医学院校采取干预措施，因为在这一人群中，帕金森病并不罕见。

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引用次数: 0

Home-based transcranial direct current stimulation (tDCS) in major depressive disorder: Enhanced network synchronization with active relative to sham and deep learning-based predictors of remission 基于家庭的经颅直流电刺激（tDCS）治疗重度抑郁障碍：增强的网络同步与主动相对于假和基于深度学习的缓解预测因子

Personalized Medicine in Psychiatry

Pub Date : 2025-03-01 DOI: 10.1016/j.pmip.2024.100147

Wenyi Xiao , Jijomon C. Moncy , Rachel D. Woodham , Sudhakar Selvaraj , Nahed Lajmi , Harriet Hobday , Gabrielle Sheehan , Ali-Reza Ghazi-Noori , Peter J. Lagerberg , Rodrigo Machado-Vieira , Jair C. Soares , Allan H. Young , Cynthia H.Y. Fu

Aim

To investigate neural oscillatory networks in major depressive disorder (MDD), effects of home-based transcranial direct current stimulation (tDCS) treatment, and predictors of treatment remission.

Methods

In a randomized controlled trial, EEG data were acquired from 21 MDD participants (16 women, mean age 36.63 ± 9.71 years) with moderate to severe depressive episodes (mean HAMD score 18.42 ± 1.80). Participants were randomized to active (n = 11) or sham tDCS (n = 8). Home-based tDCS treatment was administered for 10 weeks, with 5 sessions per week for 3 weeks, then 3 sessions per week for 7 weeks. Active tDCS was 2 mA, and sham tDCS was 0 mA with brief ramp-up/down periods. Clinical remission was defined as HAMD score ≤ 7. Resting-state EEG data were collected at baseline and at the 10-week end of treatment using a portable 4-channel EEG device. EEG band power and functional connectivity (phase locking value, PLV) were analyzed. Deep learning identified predictors of treatment remission from baseline PLV features.

Results

The active tDCS group showed higher gamma PLV in frontal and temporal regions compared to the sham group. Positive correlations between changes in delta, theta, alpha, and beta PLV and depression improvement were observed in the active group. Combining PLV features from theta, alpha, and beta achieved the highest treatment remission prediction accuracy: 71.94 % (sensitivity 52.88 %, specificity 83.06 %).

Conclusions

Synchronized brain activity in gamma PLV may be a mechanism of active tDCS. Baseline resting-state EEG could predict treatment remission. Home-based EEG measures are feasible and useful predictors of clinical outcomes.

目的探讨重度抑郁症（MDD）的神经振荡网络、家庭经颅直流电刺激（tDCS）治疗的效果及治疗缓解的预测因素。方法采用随机对照试验，收集21例中度至重度抑郁发作（平均HAMD评分18.42±1.80）的MDD患者（女性16例，平均年龄36.63±9.71岁）的脑电图数据。参与者被随机分为活动tDCS组（n = 11）和假tDCS组（n = 8）。以家庭为基础的tDCS治疗持续10周，每周5次，持续3周，然后每周3次，持续7周。活动tDCS为2 mA，假tDCS为0 mA，有短暂的上升/下降周期。HAMD评分≤7分为临床缓解。静息状态脑电图数据在基线和治疗10周结束时使用便携式4通道脑电图仪收集。分析脑电频带功率和功能连通性（锁相值，PLV）。深度学习从基线PLV特征中识别出治疗缓解的预测因素。结果与假手术组相比，活跃tDCS组额叶和颞叶的γ - PLV较高。在积极组中观察到δ、θ、α和β PLV的变化与抑郁改善呈正相关。结合theta， alpha和beta的PLV特征获得了最高的治疗缓解预测准确率：71.94%（敏感性52.88%，特异性83.06%）。结论γ - PLV脑同步活动可能是tDCS活跃的机制之一。基线静息状态脑电图可预测治疗缓解。基于家庭的脑电图测量是可行和有用的预测临床结果。

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引用次数: 0

Gene therapy for obsessive–compulsive disorder: Basic research and clinical prospects 强迫症的基因治疗：基础研究与临床展望

Personalized Medicine in Psychiatry

Pub Date : 2025-03-01 DOI: 10.1016/j.pmip.2025.100149

Fatemeh Bamarinejad , Marzieh Shokoohi , Atefeh Bamarinejad

Background

Obsessive-Compulsive Disorder (OCD) is a prevalent psychiatric condition known for its resistance to conventional treatments. Despite available pharmacological and psychotherapeutic interventions, a significant number of patients do not respond adequately to these approaches. Recent genome-wide association studies (GWAS) have identified genetic links to OCD, sparking interest in exploring gene therapy as an alternative treatment method.

Main body

Gene therapy involves correcting or replacing defective genes to target the root cause of the disorder. Preliminary studies have shown promising results, focusing on genes such as Brain Derived Neurotrophic Factor (BDNF), oxytocin receptor (OXTR), SLITRK5, and SLC6A4. Continued exploration of genes like SHANK3 and IMOOD, as well as animal models like SLITRK5 knockout mice, offer insights into potential therapeutic targets. However, ethical and technical challenges must be addressed before wider implementation can occur. Ethical considerations include the multifactorial nature of psychiatric disorders, the need for comprehensive treatment, and issues surrounding informed consent, particularly in cases where patients lack insight into their condition. Technical challenges involve safe gene delivery to the brain, potential off-target effects, and achieving optimal gene expression levels.

Conclusions

Gene therapy for OCD is still in the early stages of research and development. While current research is still in its infancy, the identification of specific genes and pathways associated with OCD offers a foundation for future therapeutic interventions. Despite the ethical and technical challenges that remain, advancements in genetic engineering and the establishment of animal models provide a hopeful outlook for the development of effective gene therapy strategies. As the field progresses, Further research is essential to fully realize the potential of gene therapy in managing OCD and related psychiatric conditions.

背景：强迫症（OCD）是一种常见的精神疾病，以其对传统治疗的抗性而闻名。尽管有可用的药理学和心理治疗干预，但相当多的患者对这些方法没有充分的反应。最近的全基因组关联研究（GWAS）已经确定了强迫症的遗传联系，激发了人们对探索基因治疗作为替代治疗方法的兴趣。基因治疗包括纠正或替换有缺陷的基因，以针对疾病的根本原因。初步研究已显示出可喜的结果，主要集中在脑源性神经营养因子（BDNF）、催产素受体（OXTR）、SLITRK5和SLC6A4等基因上。对SHANK3和IMOOD等基因以及SLITRK5敲除小鼠等动物模型的持续探索，为潜在的治疗靶点提供了新的见解。然而，在更广泛的实施之前，必须解决道德和技术上的挑战。伦理方面的考虑包括精神疾病的多因素性质、综合治疗的必要性以及与知情同意有关的问题，特别是在患者对自己的病情缺乏了解的情况下。技术上的挑战包括安全的基因传递到大脑，潜在的脱靶效应，以及达到最佳的基因表达水平。结论强迫症的基因治疗仍处于研究和开发的早期阶段。虽然目前的研究仍处于起步阶段，但与强迫症相关的特定基因和途径的识别为未来的治疗干预提供了基础。尽管伦理和技术上的挑战仍然存在，基因工程的进步和动物模型的建立为有效的基因治疗策略的发展提供了一个充满希望的前景。随着这一领域的发展，进一步的研究是必要的，以充分认识基因治疗在治疗强迫症和相关精神疾病方面的潜力。

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引用次数: 0

The burden of chronic anxiety and depression symptomatology on 20-year cardiovascular disease incidence: The ATTICA study (2002–2022) 慢性焦虑和抑郁症状负担对20年心血管疾病发病率的影响：ATTICA研究（2002-2022）

Personalized Medicine in Psychiatry

Pub Date : 2025-03-01 DOI: 10.1016/j.pmip.2025.100150

Vasiliki C. Baourda , Christina Chrysohoou , Fotios Barkas , Evrydiki Kravvariti , Evangelos Liberopoulos , Konstantinos Tsioufis , Petros P. Sfikakis , Christos Pitsavos , Demosthenes Panagiotakos

Background

The aim of this study was to explore the associations between symptoms of depression and anxiety on 20-year cardiovascular disease (CVD) incidence among apparently healthy Greek adults.

Methods

In the context of a population-based, prospective health survey, the ATTICA study (2002–2022), 853 adult participants without previous CVD history [453 men (45 ± 13 years) and 400 women (44 ± 18 years)] underwent evaluations regarding psychological factors (depression through ZDRS and anxiety through STAI scales), lifestyle factors (smoking, diet, physical activity) and medical conditions (obesity, hypertension, hypercholesterolemia, diabetes mellitus) at both baseline and 10-year follow-up examinations. CVD incidence was assessed based on medical records and hospital data. Cox proportional hazard models were developed to evaluate the association between psychological symptoms on the 20-year CVD incidence, after adjusting for various characteristics.

Results

The results indicated that the chronic burden of depression and anxiety was independently associated with increased CVD risk during the 20-year follow-up period (crude hazard ratios of cumulative at baseline and at 10-year follow-up depressive symptoms score on CVD incidence was 1.04 95%CI (1.03, 1.05), and for anxiety score was 1.03 95%CI (1.02, 1.04)); the hazard ratios were higher especially for younger participants and those who did not adhere steadily to the Mediterranean diet during the follow-up period.

Conclusions

Based on our findings, standardized psychological assessments focusing on depression and anxiety should be integrated as a distinct and additional component within the preventive strategies for CVD implemented by health authorities at the population level.

背景：本研究的目的是探讨抑郁和焦虑症状与20年来明显健康的希腊成年人心血管疾病（CVD）发病率之间的关系。方法在一项基于人群的前瞻性健康调查中，ATTICA研究（2002-2022），853名无CVD病史的成年参与者[453名男性（45±13岁）和400名女性（44±18岁）]接受了心理因素（通过ZDRS量表抑郁，通过STAI量表焦虑），生活方式因素（吸烟，饮食，体育活动）和医疗状况（肥胖，高血压，高胆固醇血症，糖尿病，糖尿病，糖尿病和糖尿病）的评估。糖尿病)基线和10年随访检查。根据医疗记录和医院数据评估心血管疾病发病率。在调整各种特征后，建立了Cox比例风险模型来评估心理症状与20年心血管疾病发病率之间的关系。结果表明，在20年随访期间，慢性抑郁和焦虑负担与CVD风险增加独立相关(基线和10年随访时，抑郁症状评分对CVD发生率的粗风险比为1.04 95%CI(1.03, 1.05)，焦虑评分为1.03 95%CI (1.02, 1.04)；风险比更高，尤其是年轻的参与者和那些在随访期间没有坚持地中海饮食的人。结论：基于我们的研究结果，应将以抑郁和焦虑为重点的标准化心理评估纳入卫生当局在人群层面实施的心血管疾病预防策略中，作为一个独特和额外的组成部分。

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引用次数: 0

Mindfulness-based cognitive therapy as an adjunctive treatment for treatment-resistant depression: A systematic review 正念认知疗法作为治疗难治性抑郁症的辅助疗法：一项系统综述

Personalized Medicine in Psychiatry

Pub Date : 2025-01-28 DOI: 10.1016/j.pmip.2025.100148

Michele F Rodrigues, Larissa Junkes, Jose Appolinario, Antonio E Nardi

Background

Treatment-Resistant Depression is a significant mental health challenge characterized by an inadequate response to standard treatments. Mindfulness-Based Cognitive Therapy has shown promise for depression, but its effectiveness for Treatment-Resistant Depression remains unclear.

Objective

This systematic review evaluated the effectiveness and safety of Mindfulness-Based Cognitive Therapy as an adjunctive treatment for Treatment-Resistant Depression.

Methods

We searched MEDLINE, Embase, Web of Science, ClinicalTrials.gov, and PsycInfo up to June 15, 2024, without language restrictions. Randomized controlled trials comparing Mindfulness-Based Cognitive Therapy plus treatment as usual to treatment as usual alone in individuals with Treatment-Resistant Depression were included. The primary outcome was depressive symptom severity. Secondary outcomes included quality of life, rumination, mindfulness skills, and self-compassion.

Results

The review included 13 studies with a total of 864 participants. Preliminary evidence suggests that Mindfulness-Based Cognitive Therapy significantly may help reduce depressive symptoms compared to treatment as usual or active controls, with effect sizes ranging from moderate to large (Cohen’s d = 0.54 to 1.04) in well-designed studies. Some improvements were also noted in quality of life (d = 0.36 to 0.51), rumination (d = 0.39), mindfulness skills (d = 0.73), and self-compassion (d = 0.21 to 0.64).

Conclusions

While encouraging, the current evidence suggests that Mindfulness-Based Cognitive Therapy maybe a promising intervention for Treatment-Resistant Depression However, methodological limitations, including heterogeneity in study designs and TRD definitions, preclude definitive conclusions. Future research should prioritize well-designed randomized controlled trials to establish its efficacy and optimal implementation.

背景：治疗难治性抑郁症是一种重要的心理健康挑战，其特征是对标准治疗的反应不足。正念认知疗法已经显示出治疗抑郁症的希望，但它对难治性抑郁症的有效性仍不清楚。目的评价正念认知疗法辅助治疗难治性抑郁症的有效性和安全性。方法我们检索MEDLINE， Embase, Web of Science, ClinicalTrials.gov和PsycInfo，截止到2024年6月15日，无语言限制。在难治性抑郁症患者中，随机对照试验比较了正念认知疗法加常规治疗与单独常规治疗。主要结局为抑郁症状严重程度。次要结果包括生活质量、沉思、正念技能和自我同情。结果本综述纳入13项研究，共864名受试者。初步证据表明，与常规治疗或主动控制相比，正念认知疗法可能显著有助于减轻抑郁症状，在设计良好的研究中，效果大小从中等到较大（科恩d = 0.54至1.04）。在生活质量（d = 0.36至0.51）、沉思（d = 0.39）、正念技能（d = 0.73）和自我同情（d = 0.21至0.64）方面也有一些改善。虽然令人鼓舞，但目前的证据表明，基于正念的认知疗法可能是治疗难治性抑郁症的一种有希望的干预措施。然而，方法学的局限性，包括研究设计和TRD定义的异质性，排除了明确的结论。未来的研究应优先考虑设计良好的随机对照试验，以确定其疗效和最佳实施。

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引用次数: 0