Psychiatria Danubina最新文献

In child and adolescent psychiatry, the clinical presentation of disorders in adolescents is complex, and categorical approaches have limitations by focusing on individual disorders. The intricate system of psychopathology during adolescence can be effectively modeled using network science, which integrates statistical and computational techniques through artificial intelligence tools. Network analysis of psychometric data from psychiatric disorder assessment tests has been extensively studied in both general psychiatry and child psychiatry. However, a comprehensive evaluation of existing network approaches that model multiple psychiatric or neurodevelopmental disorders encountered in adolescents remains necessary. We conducted a systematic literature review across two different databases - PubMed and Scopus - using the keywords "network analysis", "adolescent" and "psychiatry" to address this question. The selection of articles was based on age criteria and the number of pathological entities studied. Out of 406 articles, 69 were selected and analyzed. The results from some of these studies are described in this article. Notably, we observe significant heterogeneity in the findings, highlighting both the richness and complexity of adolescent psychopathology. Further research is needed to validate the already proposed results and standardize the models studied.

Background: Autism Spectrum Disorders (ASD) are characterized by significant challenges in social interaction and communication, accompanied by repetitive behaviors. Effective early interventions, such as the Early Start Denver Model (ESDM) are crucial but primarily studied in well-resourced Western countries. This study explores the adaptation and effectiveness of ESDM in Senegal, a low-resource setting, to adress gaps in autism care and intervention accessibility in Africa.

Subjects and methods: An observational study was conducted at Diamniadio Children's Hospital, Dakar, Senegal, from January 2019 to July 2021, focusing on children under 10 years suspected of having ASD. Diagnostic assessments were performed using the DSM-5 criteria with tools like the Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). Interventions based on ESDM were adapted to local resources and involved regular family and patient engagement.

Results: Of the 114 children referred for ASD suspicion, 80 were diagnosed with ASD. Post-diagnosis, 30 children received follow-up care at the day hospital, and another 30 were managed via outpatient care. 20 children did not receive any follow-up care at Diamniadio Children's Hospital. Significant socio-economic disparities were noted, influencing access to and engagement with intervention programs. No significant differences were found in clinical characteristics between groups, but socio-economic factors significantly affected intervention access.

Conclusion: The adapted ESDM interventions show promise for implementation in resource-limited settings like Senegal, although challenges related to socio-economic disparities and service accessibility persist. Future research should focus on the integration of ASD services into broader health policies to enhance efficacy and accessibility.

Nutritional support is considered as one of the components of disease-modifying therapy for postpartum depressive disorder. Such nutrients include iodine, which is an important trace element in the development and functioning of the central nervous system. The brief review presents updated knowledge about the relationship of iodine deficiency with the development and severity of postpartum depressive disorders in women, based on the analysis and generalization of the results of domestic and international studies.

Background: The dissolution of the Soviet Union brought economic instability and variety of social changes, resulting in fluctuating suicide rates and highlighting the national phenomenon of a melancholy cultural trait across the general population. The socio-political changes in Russia post-1991 led to increased rates of depressive and stress-related disorders, as well as opening avenues for integrating foreign psychotherapeutic methods, including Interpersonal Psychotherapy (Klerman-Weissman IPT), into the treatment of mental disorders. This narrative review explores the adaptation and efficacy of IPT in Russia, particularly for depressive and stress-related disorders.

Material and methods: We assembled key PhD theses related to the topic of IPT use in Russia. One such study involved 120 female patients aged 23-45 years with adjustment disorders, treated at the Omsk Rehabilitation Treatment Hospital. Participants were divided into an IPT group (n=80) and a control group (n=40) receiving treatment as usual (TAU). The IPT group underwent 12-16 individual sessions, each lasting 60 minutes, held twice a week. The main study group was further divided into four sub-groups based on specific interpersonal problems: loss of loved ones, interpersonal conflicts, social role changes, and social isolation.

Results: Both groups showed improvement in anxiety, dyssomnia, and motor retardation, with the IPT group demonstrating more sustained improvement. At the 8-week endpoint, full recovery from depression was observed in 50% of the IPT group, compared to only 20% in the TAU group. The IPT group also showed significant improvements in coping strategies, with a notable decrease in avoidance behaviors and an increase in problem-solving strategies, also targeting melancholy national phenomenon via training acceptance skills and practicing an active life position to aware the self-responisbility and achieve a of well-being state of emotional balance. The group IPT method was also experimentally combined with the person-oriented (reconstructive) psychotherapy, which has a long and successful history of within the group format, and has enabled shortening of the standard course of person-oriented reconstructive treatment.

Conclusions: IPT method has proven efficacy in treating depressive and stress-related disorders in Russia, by addressing deeper pathogenetic levels of mental and behavioral formations. The Russian Society of Psychiatrists and Russian Psychotherapy Association have recommended its broader implementation in Russian mental health institutions, and has included IPT in the Russian National Guidelines for Psychiatry.

This paper aims to take over the rampant phenomenon of the illicit use/abuse for volutary purposes of fentanyl. This synthetic drug is normally used as a potent anaesthetic and analgesic molecule. Unfortunately, in recent decades, this substance has conquered and seduced millions of people in the 'westernised' world, claiming numerous victims, especially young people. To this end, the most recent scientific literature will be examined and the pharmacological effects of both therapeutic and intentional abuse will be considered. Finally, the consequences and psychosocial damage produced will be described.

Depression astonishingly can be stopped instantly by electrotherapies or through some psychedelics like psilocybin. In explaining this, the traditional approaches to their antidepressant effects via "reset" models and orthosteric serotonin receptors has neglected the only serotonin channel 5HT3, which e.g. has emerged as being helpful for the neurotrophic translation for all anti-depressants and final synaptic effects. Psychedelics here are confronted with a panorama of also anti-depressant 5HT3-channels and a search for their part e.g. in the "3 pillars" reigning depression. Of these M1) mitochondria, parasitic organelles from a fusion between some proto-bacteria and archae, founding eukaryotes, also through 5HT3 in depression determine much of its somatic crises. Two further pillars, "pushback" and "shame-link", are clarified by the parasympathetic (PS-) conspiciously 5HT3-rich "nasal" pterygo-palatine ganglion (PPG): PPG-1.) Intramural "pushbacks" intoxicating brain's tissues, show up on MRI e.g. along branches of the peri-/subcallosal artery. The brain-draining circular chambers, by CIMURAF, are plausibly driven by the PPG (and other PS-ganglia) through their dense nitrergic grid, causing loose wrung areas creating hyperboloid stenoses where they delimit contracted sliding segments PPG-2.) Existential conflicts trigger last-resort attacks, whereby the subduing are stopped into submissive shame. This plausibly occurs via the antidromic "Suzuki-link" from preparatory attack-biting (V3) via the trigeminal ggl. V3-V2-crosstalk onto the PPG, which, blushing via PACAP, maybe via MCs opens the BBB causing foggy confusion. Mushrooms may have acquired psilocybin to similarly stop feeding moves of worms (C. elegans) via the >100 5HT3-like ion channels. While on MOD-1 serotonin elicits "dwelling", collective feeding on just one fungus, psilocin could on promote audacious "roaming" (protecting fungi) - channel LGC-50 learning from this. The biphasic and pervasive H₂S, being a dipole, might be flushed by ECT and on the 5HT3-receptors might get worms (and us) to move.

The microbiome is dynamic and changes with early development, environmental factors such as diet and antibiotics, and in response to disease. Recently, its role in psychiatric disorders has gained interest. A new class of probiotics, psychobiotics, has emerged as a non-toxic intervention for psychiatric conditions. The relationship between gut microbial metabolism and mental health is gaining attention, with the gut microbiome playing a role in major depressive disorder. Understanding the microbiota offers new therapeutic opportunities for various medical conditions.

Background: Post-traumatic stress disorder (PTSD) is a complex condition triggered by traumatic events. The molecular mechanisms underlying PTSD are not fully understood, but epigenetic modifications, particularly DNA methylation, may play a key role. The objective of this review was to identify the most significant epigenetic markers associated with PTSD.

Materials and methods: Our search yielded 325 articles, of which 19 met our inclusion criteria for detailed analysis: published between 2018 and 2024, original research, containing molecular-genetic and statistical data, reporting diagnostic verification methods, PTSD as a primary condition, and a sample of at least 40 patients Results: the strongest correlation was found between PTSD and methylation changes in cg17057218, cg22324981, cg04755409 of BDNF, cg05656210, cg12169700, cg20756026 of MAD1L1, HLA-DPA1, HLA-DPB1 (chr6: 33047185 - 33049505) and SPATC1L (chr21: 47604052 - 47605174). The most works on associations of genetic clock with PTSD found significantly increased GrimAge acceleration in patients with PTSD.

Conclusions: Epigenetic modifications, particularly DNA methylation, play a significant role in PTSD pathophysiology. While specific gene methylation changes are associated with PTSD, the link between PTSD and epigenetic aging remains unclear. Variability across studies suggests that trauma type, duration, and genetic factors may influence these epigenetic processes. Further research is essential to fully understand these relationships.

Introduction: In this study we examine the issue of employee burnout, caused by long-term exposure to workplace stressors, considering its complex phenomenology in the context of contemporary psychological and psychiatric views. Towards the development of innovative technologies to correct burnout in the context of psychosocial rehabilitation, we present our study protocol involving the ReViSide virtual reality (VR) and biofeedback intervention, including monitoring of respiratory rates and EEG rhythms.

Methods: The randomized controlled trial protocol includes adult participants aged 18 to 65 years (n=140) who exhibit emotional burnout in the workplace. The intervention group will undergo a course of VR correction (ReViSide), while the control group receives a standard psychocorrection. The primary endpoint will be level of emotional burnout to the Maslach Burnout Inventory (MBI). We shall also assess anxiety, depression, asthenia and subjective improvement in condition using validated scales (HADS, HARS, HDRS, VAS-A, PGI-C).

Results: We shall test our hypothesis that the VR-correction group will show significant improvements in MBI scores, particularly in emotional exhaustion, depersonalization, and personal accomplishment, compared to the control group. Secondary outcome measures are likewise expected to demonstrate more prominent improvements in the VR group, correlating with the magnitude of burnout reduction to MBI. Analysis of EEG data may reveal changes in alpha rhythm patterns during VR sessions, potentially correlating with reduced distress levels.

Conclusions: We designed this study to test the integration of an interdisciplinary approach for treating burnout, highlighting the ReViSide technology. Confirming the efficacy of this approach for psychosocial rehabilitation targeting burnout states among employees should improve their stress resilience, daily motivation, and work productivity in the context of the modern high working pressure environment and demanding corporate culture.

Background: We examined the prevalence and spread of conspiracy beliefs about the origins of the COVID-19 pandemic among representatives of the Russian population. Our study aimed to identify belief clusters and develop predictive models to understand the factors that influence conspiracy beliefs, particularly in the context of how they might evolve in response to socio-political events and cause mental disturbances, thus in relation to specific pathways of the infodemic and psychodemic waves that spread among vulnerable population groups.

Methods: Data respondents to the international COMET-G study living in Russia during pandemic period (n=7,777) were analyzed using descriptive statistics, K-means clustering, and various machine learning models, including gradient boosting. We identified distinct populations depending on predominant beliefs about COVID-19 pandemic origins, and applied game theory (Shapely additive explanations) to determine the most influential variables in predicting cluster membership.

Results: Four distinct belief clusters emerged, which we designate as Naturalists, Conspiracists, COVID-Sceptics, and the Incoherent Attitude groups. The Incoherent Attitude cluster constituted 20.8% of the sample, and was particularly associated with mental health signs such as sleep disturbances and the use of psychotropic medications. Internet use and mental health-related factors, as well as the respondents' education level, were key predictors of mental disturbances with mediating effects of the conspiracy views across all clusters. Conspiracy beliefs about COVID-19 origin were highly fluid/variable, often being shaped by external sociopolitical factors rather than objective health data.

Conclusions: The cluster with Incoherent Attitude regarding COVID-pandemic origins, which had an association with psychoticism, showed a greater predisposition for mental health problems, than did the Conspiracist, Naturalist and Sceptic clusters. We suppose that underlying psychoticism bears a relation to their sleep problems and resorting to use of psychotropic medications. These results emphasizes the global health need for implementing target-focused and selective strategies that address public misinformation and promote the adoption of critical thinking skills to mitigate the impact of conspiracy theories, considering the factors of education level and pre-existing mental disorders.