Psychiatry Research最新文献_第3页

A scientific approach to hemorrhage risk assessment of SSRIs/SNRIs utilizing the FAERS database

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-02-04 DOI: 10.1016/j.psychres.2025.116388

Xiaodan Zhou , Shixin Xiang , Bangtian Xu , Jing Xu , Youqi Long , Jia Chen , Li Chen

Objectives

Hemorrhage represents a notable adverse event (AE) associated with the utilization of SSRIs and SNRIs. This study aimed to provide valuable insights for clinical practice by providing a comprehensive understanding of hemorrhage events associated with SSRIs/SNRIs.

Methods

Ten-year data on the main SSRIs/SNRIs were extracted from the FAERS database for the period spanning from 2014 to 2023. Reporting odds ratio (ROR) and proportional reporting ratio (PRR) were employed to quantify the signals. Finally, a comparative analysis was conducted between demographic data, outcomes, and inherent associations among the medications and the signals.

Results

Approximately 3.86% of all patients who experienced adverse effects with SSRIs/SNRIs were found to have hemorrhage-related AEs (HrAEs). The majority of these patients were female and aged sixty years or older. The primary outcomes for patients experiencing HrAEs included initial or prolonged hospitalization, mortality, life-threatening conditions, and other complications. After conducting an analysis using ROR and PRR methods, we obtained several positive signals for HrAE (p-HrAEs). Gastrointestinal and nervous system disorders were identified as the predominant p-HrAEs. Sertraline demonstrated the most pronounced signals for gastrointestinal disorders, particularly upper gastrointestinal hemorrhage. Correlations have been observed between the use of citalopram, escitalopram, paroxetine, venlafaxine and cerebral/cerebellar hematoma in terms of nervous system. However, duloxetine did not result in any signals in these two systems.

Conclusions

p-HrAEs associated with SSRIs/SNRIs were identified through real-world pharmacovigilance analysis. It is anticipated that this paper will offer additional information regarding safe and rational medication for patients taking antidepressants.

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引用次数: 0

Development of serious mental illness in young adult violent offenders: Early-life risk factors and long-term adverse outcomes

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-02-02 DOI: 10.1016/j.psychres.2025.116384

André Tärnhäll , Jonas Björk , Märta Wallinius , Eva Billstedt , Björn Hofvander

This study explored serious mental illness (SMI) in young adult offenders imprisoned for violent or sexual crimes, estimating the effects of neurodevelopmental disorders and early-life risk factors on the development of SMI, and its prospective long-term adverse outcomes. An all-male cohort of 266 violent offenders, assessed during imprisonment when aged 18–25 years (M = 21.8, SD = 1.9), was followed prospectively (M_years = 6.2, SD = 1.3) in Swedish national registers together with a general population group (n = 10,000). The baseline prevalence of SMI in late adolescence or young adulthood was 10 % (n = 26) in the violent offender cohort. Childhood-onset conduct disorder (OR 2.7 [1.0–7.1]) was associated with SMI in multivariable logistic regression analyses. Prospectively, violent offenders with, versus without, SMI exhibited heightened total crime rate (IRR 1.4 [1.0–2.2]), prison reconvictions (IRR 1.5 [1.0–2.1]), and psychiatric inpatient care (IRR 3.7 [1.6–8.4]), in zero-inflated Poisson regression models. The usage of outpatient psychiatric and somatic care was low in violent offenders with SMI, even relative to the general population group. The results emphasize the need for early identification of at-risk children, such as those with childhood-onset conduct disorder, and challenges with engaging violent offenders with SMI in healthcare.

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引用次数: 0

Direct and indirect paths from subclinical symptoms of schizotypal personality to suicidal thinking among non-help-seeking adolescents

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-02-02 DOI: 10.1016/j.psychres.2025.116385

Richard J. Linscott, Theresa R. Parker

Clinical and subclinical symptoms of schizotypal personality predict concurrent and future suicidal ideation. We tested whether relationships of subclinical schizotypal symptoms with ideation operate solely via final common risk pathways for suicidal thinking, or whether there are distinctive ways that the schizotypal–ideation relationships bypass common pathways. Randomly selected 15- to 18-year-old school pupils (n = 177) self-reported on passive and active ideation; subclinical positive, negative, and disorganized symptoms, scored quantitatively; and theoretical final common pathways of thwarted belonging and burden, and of pain and hopelessness. Perceived burden and thwarted belonging, as final common pathways, provided a better account of ideation than pain and hopelessness. The relationships of schizotypal symptoms with passive ideation operated via burden and belonging. However, subclinical schizotypal symptoms had both common and distinctive links with active ideation. Some negative (excessive social anxiety) and positive symptoms (low magical thinking) bypassed burden and belonging to predict active ideation directly; for other schizotypal symptoms, only burden was a final common pathway. Negative symptoms predicted belonging but belonging was not a final common pathway to active ideation. Among adolescents with schizotypal personality, suicidal thinking may not be mitigated by improving belonging but by addressing social anxiety and perceived burden instead.

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引用次数: 0

Association between triglyceride-glucose (TyG) index and the incidence of depression in US adults with diabetes or pre-diabetes 甘油三酯-葡萄糖（TyG）指数与美国糖尿病或糖尿病前期成人抑郁症发病率之间的关系

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-02-01 DOI: 10.1016/j.psychres.2024.116328

Pengfei Shi, Jianbang Fang, Chunyang Lou

Background

The relationship between the triglyceride glucose (TyG) index and the incidence of depression in populations with diabetes or pre-diabetes remains unclear. This study aims to investigate the association between the TyG index and depression incidence in diabetic/pre-diabetic populations.

Method

Data from the 2005–2018 National Health and Nutrition Examination Survey (NHANES) were analyzed. After adjustment for confounders, multivariate logistic regression models were fitted to investigate the association between TyG index and depression incidence. Restricted cubic splines (RCS), subgroup analysis, interaction analysis, and mediation analysis were also constructed.

Results

A total of 8,970 participants with diabetes or pre-diabetes were enrolled. The linear positive association between TyG index and the incidence of depression was observed. Insulin resistance partly mediates this association in mediation analysis. There is a U-shape association between TyG index and the incidence of depression in diabetic/pre-diabetic populations whose ethnicity is Other Hispanic (p for nonlinearity =0.0237). Subgroup analysis evaluated the robustness of our findings and interaction analysis showed that this association can be modified by race/ethnicity.

Conclusion

There is a linear positive association between the TyG index and the incidence of depression in populations with diabetes or pre-diabetes.

背景：甘油三酯葡萄糖（TyG）指数与糖尿病或糖尿病前期人群抑郁发生率之间的关系尚不清楚。本研究旨在探讨糖尿病/糖尿病前期人群中TyG指数与抑郁症发病率之间的关系。方法：对2005-2018年全国健康与营养检查调查（NHANES）数据进行分析。校正混杂因素后，拟合多元logistic回归模型，探讨TyG指数与抑郁症发病率之间的关系。构建了限制性三次样条（RCS）、亚群分析、交互作用分析和中介分析。结果：共有8,970名糖尿病或糖尿病前期患者入组。TyG指数与抑郁发生率呈线性正相关。在中介分析中，胰岛素抵抗部分介导了这种关联。在其他西班牙裔的糖尿病/糖尿病前期人群中，TyG指数与抑郁症发病率呈u型相关（非线性p =0.0237）。亚组分析评估了我们研究结果的稳健性，相互作用分析表明这种关联可以被种族/民族所改变。结论：糖尿病或糖尿病前期人群中TyG指数与抑郁发生率呈线性正相关。

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引用次数: 0

Non-invasive neuromodulation treatment for depression in adolescents: A systematic review and meta-analysis 青少年抑郁症的非侵入性神经调节治疗：系统回顾和荟萃分析。

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-02-01 DOI: 10.1016/j.psychres.2024.116329

Mingcong Tang, Yi Zheng, Xiwen Zhang, Xiwang Fan

Background

Synthesized evidence regarding the effectiveness of non-invasive neuromodulation treatment for adolescents remains scarce. This study aimed to perform the first meta-analysis of the impact of neuromodulation treatment on depressive symptoms in adolescents.

Methods

According to the PRISMA guidelines, a comprehensive review covering databases in English and Chinese from their inception to November 30, 2023, was conducted. Data were pooled to compute the standardized mean difference (SMD) and risk ratio (RR), along with their respective 95 % confidence intervals (CI).

Results

A total of 27 studies involving 2075 participants were included and examined. Noninvasive neuromodulation treatment demonstrated significant positive effects on depression symptoms compared with controlled conditions (Hamilton Depression Scale (HAMD) 17: SMD = 3.503, 95 % CI = 2.404–4.602, p < 0.001; HAMD 24: SMD = 3.375, 95 % CI = 2.437–4.314, p < 0.001). High heterogeneity was observed (I² = 95.2 % and 97.2 %, p < 0.01), along with a substantial risk of publication bias (p < 0.05). In terms of the treatment response, the RR reached 1.39 (95 % CI = 1.29–1.50, p < 0.001), with low heterogeneity (I² = 35 %, p = 0.07).

Conclusions

Noninvasive neuromodulation treatment significant alleviated depressive symptoms in adolescents. Future research should prioritize conducting high-quality clinical trials to determine the suitable selection of adolescent patients for this treatment. In addition, these trials can help guide precision medicine approaches for stimulation protocols.

背景：关于青少年非侵入性神经调节治疗有效性的综合证据仍然很少。本研究旨在对神经调节治疗对青少年抑郁症状的影响进行首次荟萃分析。方法：根据PRISMA指南，对该数据库自成立至2023年11月30日的中英文数据库进行综合评价。将数据合并计算标准化平均差（SMD）和风险比（RR），以及它们各自的95%置信区间（CI）。结果：共纳入27项研究，涉及2075名受试者。与对照组相比，无创神经调节治疗对抑郁症状有显著的积极作用(汉密尔顿抑郁量表（HAMD） 17: SMD = 3.503, 95% CI = 2.404 ~ 4.602, p < 0.001；HAMD 24: SMD = 3.375, 95% CI = 2.437 ~ 4.314, p < 0.001)。观察到高度异质性（I2 = 95.2%和97.2%,p < 0.01），以及相当大的发表偏倚风险（p < 0.05）。在治疗反应方面，RR为1.39 (95% CI = 1.29-1.50, p < 0.001)，异质性较低（I2 = 35%, p = 0.07）。结论：无创神经调节治疗可显著缓解青少年抑郁症状。未来的研究应优先进行高质量的临床试验，以确定青少年患者的合适选择。此外，这些试验可以帮助指导刺激方案的精准医学方法。

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引用次数: 0

The structure of meaning in schizophrenia: A study of spontaneous speech in Chinese 精神分裂症的意义结构：汉语自发言语的研究。

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-02-01 DOI: 10.1016/j.psychres.2024.116347

Han Zhang , Rui He , Claudio Palominos , Ning Hsu , Hintat Cheung , Wolfram Hinzen

Narrative speech production requires the retrieval of concepts to refer to entities, which need to be referenceable more than once for any form of narrative coherence to arise. Such coherence has long been observed to be affected in schizophrenia spectrum disorders (SSD), yet the underlying mechanisms have been a longstanding puzzle, with existing evidence predominantly derived from Indo-European languages. Here we analyzed two picture descriptions from 22 native Mandarin Chinese speakers with SSD and 15 healthy controls. An analysis scheme was created targeting key mechanisms in the genesis of referential meaning in speech. Results revealed that individuals with SSD used more definite-anaphoric noun phrases (NPs), which refer back to a previously mentioned entity in a narrative, and fewer NPs with adjectival modifiers. Definite NPs appeared earlier in their speech, and both definite and indefinite NPs occurred at shorter temporal distances. Participants with SSD referenced fewer entities, which in turn were more recurrent (referenced more than once). Furthermore, speech graphs capturing how entities are referenced across a narrative exhibited higher clustering, centrality, density, and shorter characteristic path lengths in SSD. Overall, these results from a non-Indo-European language support the new concept of a ‘shrinking’ or more condensed semantic space in SSD, impeding normal mental navigation across the concepts we retrieve during speech.

叙事性言语的产生需要对指代实体的概念进行检索，这些实体需要被多次引用才能产生任何形式的叙事连贯性。长期以来，人们一直观察到这种一致性在精神分裂症谱系障碍（SSD）中受到影响，但其潜在机制一直是一个长期存在的谜团，现有证据主要来自印欧语言。在这里，我们分析了22名母语为普通话的SSD患者和15名健康对照者的两幅图片描述。针对言语中指称意义产生的关键机制，建立了一个分析方案。结果显示，患有SSD的个体使用更多的明确回指名词短语（NPs），这些短语指的是叙述中先前提到的实体，而使用形容词修饰语的NPs较少。确定NPs出现时间较早，确定NPs和不确定NPs出现的时间距离均较短。具有SSD的参与者引用较少的实体，而这些实体又更频繁（引用不止一次）。此外，捕捉实体如何在叙述中被引用的语音图在SSD中表现出更高的聚类、中心性、密度和更短的特征路径长度。总的来说，这些来自非印欧语言的结果支持了SSD中“缩小”或更浓缩的语义空间的新概念，阻碍了我们在讲话中检索概念的正常心理导航。

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引用次数: 0

Exploring delusional themes and other symptoms in first episode psychosis: A network analysis over two timepoints 探索妄想主题和其他症状在首发精神病：两个时间点的网络分析。

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-02-01 DOI: 10.1016/j.psychres.2024.116349

Fjolla Berisha , Vincent Paquin , Ian Gold , Bratislav Misic , Lena Palaniyappan , Ashok Malla , Srividya Iyer , Ridha Joober , Martin Lepage , Jai Shah

Delusions are a defining feature of psychosis and play an important role in the conceptualization and diagnosis of psychotic disorders; however, the particular role that different delusions play in the prognosis of these disorders is not well understood. This study explored relationships between delusions and other symptoms in 674 first episode psychosis (FEP) individuals by comparing symptom networks between baseline and 12 months after intake to an early intervention service. Specifically, we (1) estimated regularized partial correlation networks at baseline and month 12, (2) identified the most central symptoms in each network, (3) identified clusters of highly connected symptoms, and (4) compared networks to examine changes in structure and connectivity. At baseline, the most central symptoms were depression, delusions of mind reading, and delusions of thought insertion. At month 12, they were hallucinations, persecutory delusions, and delusions of thought insertion. A symptom cluster was identified at both timepoints comprising of five delusions corresponding to passivity experiences. While network structures did not differ significantly, the month 12 network was significantly more highly connected. Our study captures a shift in illness trajectory over time, wherein transdiagnostic symptomatology at baseline becomes more consolidated around psychotic symptoms by month 12.

妄想是精神病的定义特征，在精神障碍的概念化和诊断中起着重要作用；然而，不同的妄想在这些疾病的预后中所起的特殊作用尚不清楚。本研究对674名首发精神病（FEP）患者进行了早期干预治疗，通过比较基线和12个月后的症状网络，探讨了妄想和其他症状之间的关系。具体来说，我们(1)估计了基线和第12个月的正则化部分相关网络，(2)确定了每个网络中最核心的症状，(3)确定了高度关联症状的集群，(4)比较网络以检查结构和连通性的变化。在基线时，最主要的症状是抑郁、读心术妄想和思想插入妄想。在第12个月时，他们出现了幻觉，受迫害妄想和思想插入妄想。在两个时间点上确定了一个症状集群，包括与被动性经验相对应的五种妄想。虽然网络结构没有显著差异，但第12个月的网络连接程度明显更高。我们的研究捕获了疾病轨迹随时间的变化，其中基线的跨诊断症状学在第12个月时围绕精神病症状变得更加巩固。

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引用次数: 0

Examining the potential of an internet-based emotion regulation intervention added to acute psychiatric inpatient care: results from a randomized controlled pilot trial 检查基于网络的情绪调节干预增加到急性精神病住院治疗的潜力：来自随机对照试点试验的结果。

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-02-01 DOI: 10.1016/j.psychres.2024.116326

Gwendolyn Wälchli , Thomas Berger , Christoph Nissen , Franz Moggi , Laura Luisa Bielinski

The feasibility and the preliminary effectiveness of an internet-based emotion regulation intervention added to acute psychiatric inpatient care were assessed with a randomized controlled pilot trial. Sixty patients were allocated in a 1:1 ratio to the intervention group or treatment as usual (TAU). Feasibility was evaluated via patient satisfaction, system usability, and program usage. The primary outcome was symptom severity (Brief-Syptom-Inventory-18-GSI), secondary outcomes included two emotion regulation measures. Assessments occurred at baseline, after four weeks (T1), eight weeks (T2), and patient discharge. Satisfaction scores (CSQ-8: M = 2.97, SD = 0.64) and usability ratings (SUS: M = 69.89, SD = 10.34) were positive. Program usage was low, with only 12 of 30 patients completing at least 50 % of the program. In the ITT-analysis, no significant group-by-time interaction effects were found for symptom severity or emotion regulation. Descriptively, effect sizes favored the intervention for symptom severity at T1 (d = 0.16) and T2 (d = 0.12) and favored TAU for the emotion regulation parameters at both time points. Thus, while the internet-based program showed good usability and satisfaction, it did not significantly impact symptom severity or emotion regulation. Future research should examine how to enhance program use in this treatment context.

本研究采用随机对照先导试验，评估以网路为基础的情绪调节介入急性精神科住院病人护理的可行性及初步效果。60例患者按1:1的比例分配到干预组或照常治疗组（TAU）。可行性通过患者满意度、系统可用性和程序使用情况进行评估。主要结局是症状严重程度（brief - symptom - inventory -18- gsi），次要结局包括两项情绪调节测量。评估分别在基线、4周（T1）、8周（T2）和患者出院后进行。满意度评分（CSQ-8: M = 2.97, SD = 0.64）和可用性评分（SUS: M = 69.89, SD = 10.34）为正。计划的使用率很低，30名患者中只有12名完成了至少50%的计划。在itt分析中，在症状严重程度或情绪调节方面没有发现显著的群体-时间交互效应。描述性地，效应量在T1 （d = 0.16）和T2 （d = 0.12）时对症状严重程度的干预有利，在两个时间点对情绪调节参数的干预都有利。因此，虽然基于互联网的程序显示出良好的可用性和满意度，但它对症状严重程度或情绪调节没有显著影响。未来的研究应该研究如何在这种治疗背景下加强程序的使用。

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引用次数: 0

Prevalence and factors related to psychological distress among Ebola survivors and healthcare workers in the Eastern DR Congo 刚果（金）东部埃博拉幸存者和医护人员的心理困扰发生率及相关因素。

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-02-01 DOI: 10.1016/j.psychres.2024.116319

Jude Mary Cénat , Seyed Mohammad Mahdi Moshirian Farahi , Jacqueline Bukaka , Rose Darly Dalexis

This article examines for the first-time prevalence and factors associated with psychological distress among Ebola survivors and healthcare workers (HCWs). A representative sample of 563 participants completed the survey (309 survivors; 202 HCWs; 52 survivors/HCWs). Prevalence of psychological distress was higher among survivors (85.25 %) compared to HCWs (51.24 %), and combined group (73.08 %), χ2=69.32, p<.001. Logistic regression models showed that COVID-19 (OR=1.02, 95 %CI: [1.01–1.03], p=.005) and Ebola stigmatization (OR=1.06, 95 %CI: [1.04–1.07], p<.001) were the most important predictors of psychological distress. Significant main effects of social support (B=-.05, p=.001) was observed. This study shows the need of implementing culturally adapted trauma-informed prevention and intervention programs among survivors and HCWs.

本文首次研究了埃博拉幸存者和医护人员（HCWs）中心理困扰的发生率和相关因素。有代表性的 563 名参与者完成了调查（309 名幸存者；202 名医护人员；52 名幸存者/医护人员）。与医护人员（51.24%）和综合组（73.08%）相比，幸存者（85.25%）的心理困扰发生率更高，χ2=69.32，P＜0.05。

引用次数: 0

Insight into potential long COVID effects: Antidepressant use in post SARS-CoV-2 Infection scenarios. A multiregional nested case-control study 洞察COVID的潜在长期影响：抗抑郁药在SARS-CoV-2感染后的使用情况多地区巢式病例对照研究。

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-02-01 DOI: 10.1016/j.psychres.2024.116290

Valentina Rosolen , Yvonne Beorchia , Luigi Castriotta , Caterina Fanizza , Francesco Profili , Marco Floridia , Marina Giuliano , Flavia Pricci , Marika Villa , Tiziana Grisetti , Tiziana Grassi , Dorina Tiple , Andrea Silenzi , Paolo Francesconi , Lucia Bisceglia , Fabio Barbone , Silvio Brusaferro , Graziano Onder

This study aimed to investigate the impact of previous SARS-CoV-2 infection and the role of vaccination in the onset of neuropsychiatric conditions, evaluated through antidepressant prescriptions. This case-control study evaluated the risk of new antidepressant prescriptions in relation to previous exposure to SARS-CoV-2 infection and vaccination. It was conducted in three Italian Regions on adults who did not receive antidepressant prescriptions in the year preceding the study period. Individuals with newly prescribed antidepressants (cases) were matched by sex and age to non-users of antidepressants (controls). Pooled estimates of regional Odds Ratios (ORs) were obtained through a meta-analysis. Findings showed that individuals previously infected with SARS-CoV-2 had a higher risk of receiving a new prescription of antidepressants. Moreover, this association was stronger among subjects hospitalized due to infection, and SARS-CoV-2 vaccination may have acted as an effect modifier by reducing that risk. In fact, the pooled OR for receiving a new antidepressant prescription was higher for unvaccinated individuals than for those vaccinated. The results of this study confirm the role of SARS-CoV-2 infection as a risk factor for the onset of neuropsychiatric symptoms. Antidepressant treatment initiation was much more likely after severe COVID-19 infection but vaccination reduced such a risk.

本研究旨在通过抗抑郁药处方评估既往SARS-CoV-2感染的影响和疫苗接种在神经精神疾病发病中的作用。本病例对照研究评估了新的抗抑郁药物处方与先前暴露于SARS-CoV-2感染和疫苗接种之间的关系。这项研究在意大利的三个地区进行，研究对象是在研究前一年没有接受过抗抑郁药物处方的成年人。新开抗抑郁药处方的个体（病例）按性别和年龄与未使用抗抑郁药的个体（对照组）相匹配。通过荟萃分析获得区域优势比（ORs）的汇总估计。研究结果显示，以前感染过SARS-CoV-2的个体接受新处方抗抑郁药的风险更高。此外，这种关联在因感染而住院的受试者中更强，而SARS-CoV-2疫苗可能通过降低这种风险而起到了效果调节剂的作用。事实上，未接种疫苗的人接受新的抗抑郁药处方的综合OR高于接种疫苗的人。本研究结果证实了SARS-CoV-2感染作为神经精神症状发病的危险因素的作用。在严重感染COVID-19后开始抗抑郁治疗的可能性要大得多，但接种疫苗可以降低这种风险。

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引用次数: 0