Psychiatry Research最新文献_第5页

Perioperative administration of esketamine during cesarean section is a double-edged sword 在剖腹产手术中围手术期使用艾司氯胺酮是一把双刃剑。

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-02-01 DOI: 10.1016/j.psychres.2024.116321

Takahiko Nagamine

引用次数: 0

Autism spectrum disorder and anorexia nervosa: Investigating the behavioural and neurocognitive overlap 自闭症谱系障碍和神经性厌食症：行为和神经认知重叠的研究。

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-02-01 DOI: 10.1016/j.psychres.2024.116285

M. Kirkovski , G. Papavasiliou , B.E. Speranza , J. Scarfo , N. Albein-Urios , J. Linardon , A. Phillipou , M. Fuller-Tyszkiewicz , P.G. Enticott

Autism spectrum disorder (autism) and anorexia nervosa (AN) share many clinical features. Two key neurocognitive correlates of the autistic dyad, specifically, mentalising (social impairment) and set-shifting (restricted and repetitive behaviours/interests [RRBI]) were investigated in a sample of 327 adult participants with autism (n = 100; 50 females, 50 male), AN (n = 82; 54 females, 28 male), autism and AN (n = 45; 36 females, 9 male), and 100 (50 female, 50 male) control participants from the general population. A battery of self-report (Autism Spectrum Quotient, Eating Disorder Examination Questionnaire, Reflective Function Questionnaire, and Repetitive Behaviour Questionnaire 2 – Adult version) and performance-based (Wisconsin Card Sort Task [WCST] and Penn Emotion Recognition Test [ER-40]) measures were administered online. Clinical participants reported greater mentalising difficulty, more repetitive behaviour, and displayed worse mentalising ability compared to controls, with no difference between the clinical groups. Eating disorder psychopathology predicted error (total and perseverative) rates on the WCST, while lower levels of autistic traits were positively associated with ER-40 accuracy. We provide evidence that clinical features of autism and AN might have specific neurocognitive relevance. Improved understanding of the mechanisms underlying the overlapping features of autism and AN can have critical implications for early detection and improved and tailored intervention.

自闭症谱系障碍（Autism spectrum disorder, Autism）和神经性厌食症（anorexia neurosa， AN）有许多共同的临床特征。研究人员对327名成年自闭症患者(n = 100；女性50例，男性50例),AN (n = 82；女性54例，男性28例)、自闭症和AN (n = 45；36名女性，9名男性)和100名（50名女性，50名男性）来自普通人群的对照参与者。采用自述（自闭症谱系商、饮食失调检查问卷、反思功能问卷和重复行为问卷2 -成人版）和基于表现的威斯康星卡片分类任务（WCST）和宾夕法尼亚情绪识别测试（ER-40）进行在线测试。与对照组相比，临床参与者报告了更大的思维困难，更多的重复行为，并且表现出更差的思维能力，临床组之间没有差异。饮食失调精神病理学预测WCST的错误率（总错误率和持续性错误率），而较低水平的自闭症特征与ER-40的准确性呈正相关。我们提供证据表明自闭症的临床特征和AN可能具有特定的神经认知相关性。更好地理解自闭症和AN重叠特征背后的机制对早期发现和改进和有针对性的干预具有重要意义。

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引用次数: 0

Latent classes of acute grief reactions in the shadow of collective trauma and its predictors in bereaved adults 丧亲成人集体创伤阴影下急性悲伤反应的潜在类别及其预测因子。

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-02-01 DOI: 10.1016/j.psychres.2024.116331

Yaira Hamama-Raz, Menachem Ben-Ezra, Yafit Levin

The current study explored grief reaction profiles after the October 7th, 2023, Israeli massacre regarding the loss of significant others. It investigated factors worsening pre-existing grief in 2,028 adult civilians, with 1,263 reporting pre- or post-massacre loss. Participants completed self-reports on prolonged grief disorder (PGD), post-traumatic stress disorder (PTSD), complex PTSD (CPTSD), cognitive emotional regulation (CER), and assumptive worldviews. Latent class analysis identified four classes of probable PGD among those with lifetime loss: "high PGD—both core and emotional pain" (35.9 %); "Medium PGD—emotional pain" (6.9 %); "medium to high PGD—high core, medium emotional pain" (23 %); and "low PGD—both core and emotional pain" (34.5 %). The subsample analysis of individuals experiencing lifetime loss with concurrent October 7th loss indicated three classes of probable PGD: "high PGD symptoms" (47.9 %), "high to medium PGD—high core with medium emotional pain symptoms" (15.9 %), and “low PGD symptoms” (36.2 %). The subsample analysis of those who experienced concurrent recent loss related to the October 7th attack showed two classes related to indicative of acute grief: "high PGD symptoms” (69 %), and “low PGD symptoms” (31 %). Negative CER coping strategies were associated significantly with the high PGD in all three groups, and with increased risk of PTSD and CPTSD symptoms compared to the "low PGD symptoms" group. Collective bereavement amid collective trauma can activate prior individual grief reactions, even without current losses from the traumatic event. Those experiencing loss tied to severe traumatic events may face higher susceptibility to developing pathological grief.

目前的研究探讨了2023年10月7日以色列大屠杀后的悲伤反应概况，这是由于失去了重要的其他人。该研究调查了2028名成年平民中加剧先前悲伤的因素，其中1263人报告了大屠杀前后的损失。参与者完成了长时间悲伤障碍（PGD）、创伤后应激障碍（PTSD）、复杂创伤后应激障碍（CPTSD）、认知情绪调节（CER）和假设世界观的自我报告。潜在分类分析在终生丧失的患者中确定了四种可能的PGD：“高PGD-核心和情感痛苦”（35.9%）；“中度pgd -情绪痛苦”（6.9%）；“中至高pgd -高核心，中度情绪痛苦”（23%）；“低pgd -核心疼痛和情绪疼痛”（34.5%）。对同时经历10月7日损失的终生损失个体的亚样本分析表明，PGD可能分为三类：“高PGD症状”（47.9%）、“高至中等PGD-高核心伴中等情绪疼痛症状”（15.9%）和“低PGD症状”（36.2%）。对那些经历了与10月7日袭击相关的近期损失的人的子样本分析显示，与急性悲伤相关的两类：“高PGD症状”（69%）和“低PGD症状”（31%）。在所有三组中，负性CER应对策略与高PGD显著相关，并且与“低PGD症状”组相比，PTSD和CPTSD症状的风险增加。集体创伤中的集体丧亲可以激活先前的个人悲伤反应，即使目前没有创伤事件造成的损失。那些经历与严重创伤事件相关的损失的人可能更容易发展为病理性悲伤。

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引用次数: 0

Efficacy of bright light therapy improves outcomes of perinatal depression: A systematic review and meta-analysis of randomized controlled trials 亮光治疗改善围产期抑郁症的疗效：随机对照试验的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.2024.116303

Lian Du , Jinkun Zeng , Hua Yu , Bijun Chen , Wei Deng , Tao Li

The efficacy of bright light therapy (BLT) in the context of perinatal depression remains underexplored. This meta-analysis aimed to systematically assess the effectiveness of BLT among perinatal depression. A comprehensive literature search was performed across several databases, including the Cochrane Central Register of Controlled Trials, PubMed, Embase, CNKI and the clinical trials registry platform, covering the period from the inception of each database up to January 2024. The Cochrane Collaboration's bias assessment tool was employed to evaluate the quality of the included studies. Review Manager 5.3 Software was utilized to conduct the meta-analysis. Six trials, encompassed a total of 167 participants diagnosed with perinatal depression were incorporated quantitative analysis, all of those have been published in English, with no restriction on publication year, and used BLT and dim light therapy (DLT) as intervention. The relative risk (RR) of BLT compared to DLT for perinatal depression is 1.46 (fixed effects model, p = 0.04, 95 % CI = [1.02, 2.10]), indicating a significant improvement in depression outcomes compared to DLT groups. The heterogeneity test yielded an I² value of 41 % (p = 0.13), indicated a low degree of heterogeneity. Considering the small sample size, we conducted a sensitivity analysis, found RR increased to 2.33 (fixed effects model, p = 0.001, CI = 1.39–3.92). Cochrane Risk of Bias Tool showed only a single study was deemed high quality. This study indicates a beneficial impact of BLT on perinatal depression, subgroup analysis finds no significant mediation effects of different parameters after sensitivity analyses. It is recommended that future studies with larger samples be conducted to explore the effects of BLT on perinatal depression.

明亮光疗法（BLT）在围产期抑郁症中的疗效仍未得到充分探讨。本荟萃分析旨在系统评估BLT治疗围产期抑郁症的有效性。我们对多个数据库进行了全面的文献检索，包括Cochrane Central Register of Controlled Trials、PubMed、Embase、CNKI和临床试验注册平台，检索时间从每个数据库建立到2024年1月。采用Cochrane Collaboration的偏倚评估工具评估纳入研究的质量。采用Review Manager 5.3软件进行meta分析。6项试验纳入了167名被诊断为围产期抑郁症的参与者，所有试验均以英文发表，不限制发表年份，并采用BLT和昏暗光疗法（DLT）作为干预措施。与DLT组相比，BLT组围产期抑郁的相对危险度（RR）为1.46（固定效应模型，p = 0.04, 95% CI =[1.02, 2.10]），表明与DLT组相比，BLT组抑郁结局有显著改善。异质性检验的I2值为41% (p = 0.13)，表明异质性程度较低。考虑到样本量小，我们进行了敏感性分析，发现RR增加到2.33（固定效应模型，p = 0.001, CI = 1.39 ~ 3.92）。Cochrane风险偏倚工具显示，只有一项研究被认为是高质量的。本研究提示BLT对围产期抑郁有有益影响，亚组分析经敏感性分析发现不同参数的中介作用不显著。我们建议未来进行更大样本的研究，以探索BLT对围产期抑郁的影响。

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引用次数: 0

Efficacy and safety of psilocybin in the treatment of Major Depressive Disorder (MDD): A dose-response network meta-analysis of randomized placebo-controlled clinical trials 裸盖菇素治疗重度抑郁症（MDD）的疗效和安全性：随机安慰剂对照临床试验的剂量-反应网络meta分析

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-02-01 DOI: 10.1016/j.psychres.2024.116337

Damian Swieczkowski , Aleksander Kwaśny , Michal Pruc , Zuzanna Gaca , Lukasz Szarpak , Wiesław J. Cubała

Selecting the optimal dose of psilocybin for treating Major Depressive Disorder (MDD) and Treatment-Resistant Depression (TRD) is crucial for clinical development and regulatory approval. This meta-analysis evaluates psilocybin's efficacy and safety in treating MDD to determine the optimal dose and timing for clinical trials. A systematic review and Dose-Response Network Meta-Analysis (NMA) of Randomized Placebo-Controlled Clinical Trials (RCTs) registered with PROSPERO was conducted. Databases searched included Embase, PubMed, Cochrane Library, Scopus, Web of Science, and Google Scholar, up to July 2024. The PICOS framework defined eligibility criteria: P: adult patients with MDD; I: psilocybin; C: placebo; O: changes in MADRS scores at Days 2, 8 and 15, and adverse events; S: RCT. Independent researchers performed data extraction and bias assessment. From 5419 search results, three RCTs involving 389 patients were included. Psilocybin significantly reduced symptoms compared to placebo at Day 8 (MD = -7.42; 95 % CI:10.07 to -4.78; p < 0.001) and Day 15 (MD = -9.55; 95 % CI:12.44 to -6.65; p < 0.001), without significant effects on Day 2. The NMA indicated that a 25 mg dose was the most effective, with a SUCRA value of 92.25 %, compared to doses of 0.215 mg/kg and 10 mg. However, psilocybin was associated with a higher risk of adverse events, particularly nausea (RR = 8.35; p < 0.001). This meta-analysis supports psilocybin's efficacy in treating MDD, particularly at a 25 mg dose, showing a time-dependent therapeutic effect. The recommended timing of efficacy evaluation by regulatory authorities is validated by this evidence, underscoring its importance in clinical trial design for psychedelic substances.

选择最佳剂量的裸盖菇素治疗重度抑郁症（MDD）和难治性抑郁症（TRD）对于临床开发和监管审批至关重要。本荟萃分析评估裸盖菇素治疗重度抑郁症的疗效和安全性，以确定临床试验的最佳剂量和时间。对在PROSPERO注册的随机安慰剂对照临床试验（RCTs）进行了系统评价和剂量反应网络meta分析（NMA）。检索的数据库包括Embase、PubMed、Cochrane Library、Scopus、Web of Science和谷歌Scholar，截止到2024年7月。PICOS框架定义了入选标准：P：成年重度抑郁症患者；我:裸盖菇素;C:安慰剂;O：第2、8和15天MADRS评分的变化以及不良事件；个随机对照试验。独立研究人员进行了数据提取和偏倚评估。从5419个检索结果中，纳入了3个rct，涉及389例患者。与安慰剂相比，裸盖菇素在第8天显著减轻了症状(MD = -7.42；95% CI:10.07至-4.78；p < 0.001)和第15天(MD = -9.55；95%置信区间：12.44至-6.65；p < 0.001)，第2天无显著影响。NMA表明，与0.215 mg/kg和10 mg剂量相比，25 mg剂量最有效，SUCRA值为92.25%。然而，裸盖菇素与不良事件的高风险相关，特别是恶心(RR = 8.35；P < 0.001)。这项荟萃分析支持裸盖菇素治疗重度抑郁症的疗效，特别是在25毫克剂量时，显示出时间依赖性的治疗效果。这一证据证实了监管机构推荐的疗效评估时间，强调了其在致幻剂临床试验设计中的重要性。

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引用次数: 0

The unfolding of psychological distress following the October 7 attack on Israel: The impact of exposure, gender, and event centrality 10 月 7 日以色列遭受袭击后心理压力的发展：暴露、性别和事件中心性的影响。

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-02-01 DOI: 10.1016/j.psychres.2025.116356

Eva Gilboa Schechtman , Dan E. Hay , Itai Schwartz , Yuval Neria , David Roe

Background

Mass disasters, whether natural or human-made, pose significant public health challenges, with some individuals demonstrating resilience, whereas others experience persistent emotional distress that may meet diagnostic criteria for mental health disorders. We explored key risk factors for distress following the October 7, 2023, Hamas attacks on Israel, focusing on trauma exposure, gender, and event centrality.

Method

A longitudinal study design was used, assessing posttraumatic distress (PTSD), depression, generalized anxiety, event centrality, and functioning at approximately three (T1; n=858) and seven (T2, n=509) months post-attack.

Results

Replicating findings from war trauma literature, we documented a high comorbidity among PTSD, depression, and anxiety; greater distress in women; and a dose-response relationship between exposure and distress. Event centrality was consistently linked to distress at both time points. Extending the literature, we found that gender, exposure, and event centrality contributed to distress at each time point. Moreover, important gender-specific patterns of risk and distress were revealed. In addition, distress at T1, event centrality at T1, gender, and continuous exposure contributed to distress at T2. Whereas distress and event centrality remained stable, functioning improved significantly from T1 to T2, highlighting the different trajectories of distress and recovery.

Conclusions

Personalized approaches and continuous monitoring of individuals exposed to cumulative trauma are highlighted. The importance of assessing multiple indices of trauma – distress, functioning, and meaning –to address mental health needs in the wake of mass disasters is emphasized.

背景：大规模灾害，无论是自然灾害还是人为灾害，都对公共卫生构成重大挑战，一些人表现出复原力，而另一些人则经历持续的情绪困扰，可能符合精神健康障碍的诊断标准。我们探讨了2023年10月7日哈马斯袭击以色列后造成痛苦的主要风险因素，重点是创伤暴露、性别和事件中心性。方法：采用纵向研究设计，评估创伤后应激障碍（PTSD）、抑郁、广泛性焦虑、事件中心性和大约三(T1；n=858)和7个月（T2, n=509）。结果：重复战争创伤文献的发现，我们记录了创伤后应激障碍、抑郁和焦虑的高合并症；女性的痛苦更大；暴露和痛苦之间的剂量-反应关系。在两个时间点上，事件中心性始终与痛苦有关。扩展文献，我们发现性别、暴露和事件中心性对每个时间点的痛苦有贡献。此外，还揭示了不同性别的风险和痛苦的重要模式。此外，T1时的痛苦、T1时的事件中心性、性别和持续暴露对T2时的痛苦也有影响。虽然痛苦和事件中心性保持稳定，但功能从T1到T2显著改善，突出了痛苦和恢复的不同轨迹。结论：个性化方法和持续监测暴露于累积性创伤的个体是突出的。强调了评估创伤的多重指标——痛苦、功能和意义——以解决大规模灾难后的心理健康需求的重要性。

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引用次数: 0

Efficacy of internet-delivered universal and tailored transdiagnostic interventions for anxiety and depression: A systematic review and meta-analysis of randomized controlled trials 针对焦虑症和抑郁症的互联网普及型和定制型跨诊断干预措施的疗效：随机对照试验的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.2024.116324

JiaLi Liu , ChaoYang Li , YuFei Qiu , YiQing Yu , LiJuan Zeng , Man Wu , YangYang Han , Fen Yang

Background

Internet-delivered transdiagnostic psychological interventions are promising approaches for the treatment of anxiety and depression. This study aimed to review and synthesize evidence related to the effectiveness of Internet-based transdiagnostic interventions for reducing anxiety and depression, and to compare the effects of universal versus tailored interventions.

Methods

A Systematic review search was conducted on the PubMed, EMBASE, Cochrane Library, Web of Science, PsychINFO, Medline, and CINAHL databases as of 28 March 2024. Two researchers made their choices based on consensus. This study performed a random-effects meta-analysis comparing patients receiving Internet-based transdiagnostic therapy with a control group, and examined the effects on depression, anxiety, and quality of life. This meta-analysis compared the effect of Internet-delivered universal and tailored transdiagnostic on anxiety and depression.

Results

42 trials were identified with a total of 4982 participants. Compared with the control group, the Internet-delivered transdiagnostic intervention reduced anxiety and depression symptoms (g = −0.617, 95 % CI: −0.699 to −0.535), anxiety (g = −0.580, 95 % CI: −0.690 to −0.470), depression (g = −0.650, 95 % CI: −0.770 to −0.530). The Internet-delivered universal transdiagnostic treatment was more effective than tailored transdiagnostic in improving anxiety and depression. Internet-delivered transdiagnostic interventions also had a positive impact on quality of life (g = 0.310; 95 % CI: 0.130 to 0.490).

Conclusions

This meta-analysis demonstrates that Internet-based transdiagnostic interventions are effective for treating anxiety and depression, and can also improve quality of life. The universal Internet-delivered transdiagnostic intervention is better than the tailored intervention. Future studies should investigate the mechanisms of change and develop outcome measures for these interventions.

背景：互联网传递的跨诊断心理干预是治疗焦虑和抑郁的有希望的方法。本研究旨在回顾和综合与基于互联网的跨诊断干预减少焦虑和抑郁的有效性相关的证据，并比较通用干预和定制干预的效果。方法：系统检索截至2024年3月28日的PubMed、EMBASE、Cochrane Library、Web of Science、PsychINFO、Medline和CINAHL数据库。两位研究人员根据共识做出了选择。本研究进行了随机效应荟萃分析，比较了接受基于互联网的跨诊断治疗的患者与对照组，并检查了对抑郁、焦虑和生活质量的影响。这项荟萃分析比较了互联网提供的通用和定制的跨诊断对焦虑和抑郁的影响。结果：共纳入42项试验，4982名受试者。与对照组相比，互联网传递的跨诊断干预减少了焦虑和抑郁症状（g = -0.617, 95% CI: -0.699至-0.535），焦虑（g = -0.580, 95% CI: -0.690至-0.470），抑郁（g = -0.650, 95% CI: -0.770至-0.530）。在改善焦虑和抑郁方面，互联网提供的通用转诊治疗比量身定制的转诊更有效。互联网提供的跨诊断干预对生活质量也有积极影响(g = 0.310；95% CI: 0.130 ~ 0.490)。结论：本荟萃分析表明，基于互联网的跨诊断干预对治疗焦虑和抑郁是有效的，并且还可以改善生活质量。通用互联网提供的跨诊断干预优于量身定制的干预。未来的研究应该调查变化的机制，并为这些干预措施制定结果措施。

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引用次数: 0

Efficacy of internet-based cognitive behavioral therapy for medicated adults with attention-deficit/hyperactivity disorder (ADHD): A randomized controlled trial 基于网络的认知行为疗法对服药成人注意力缺陷/多动障碍（ADHD）的疗效：一项随机对照试验

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-02-01 DOI: 10.1016/j.psychres.2025.116352

Shi-Yu Zhang , Mei-Rong Pan , Li-Qian Zhang , Hai-Mei Li , Meng-Jie Zhao , Min Dong , Fei-Fei Si , Lu Liu , Yu-Feng Wang , Qiu-Jin Qian

Background

Cognitive behavioral therapy (CBT) is an effective treatment for adults with attention-deficit/hyperactivity disorder (ADHD), but its use is limited by poor accessibility and time constraints—barriers that internet-based CBT (iCBT) may help overcome. This trial aimed to explore the short- and long-term efficacy of iCBT in medicated adults with ADHD.

Methods

Eighty-six adults with ADHD were randomized into two groups: the iCBT combined with medication group (iCBT+M, n = 43) and the medication-only group (n = 43). The iCBT+M group received 12 weeks of iCBT with ongoing medication, while the medication-only group continued with medication alone. The primary outcome was the change in ADHD symptoms. Secondary outcomes included emotional symptoms, executive function, quality of life, and global functioning. Outcomes were assessed at baseline, post-treatment (T1), 6-month (T2), and 12-month follow-up (T3). Mixed linear models were used to assess the differences in outcomes between the two groups at each follow-up point.

Results

Compared to the medication-only group, the iCBT+M group showed greater improvements in ADHD symptoms (d = 0.50 at T1/T2, 0.59 at T3), executive function (d = 0.87 at T1, 0.49 at T2, 0.25 at T3), quality of life (d = -0.74 at T1, -0.59 at T2, -0.28 at T3), global functioning (d = 0.66 at T1, 0.85 at T2, 0.42 at T3), and anxiety (d = 0.43 at T1).

Conclusion

iCBT interventions may benefit medicated adults with ADHD by improving core symptoms, executive function, quality of life, and overall functioning, with effects sustained for 12 months.

背景：认知行为疗法（CBT）是一种有效的成人注意力缺陷/多动障碍（ADHD）的治疗方法，但它的使用受到较差的可及性和时间限制的限制——基于互联网的CBT （iCBT）可能有助于克服这些障碍。本试验旨在探讨iCBT治疗ADHD的短期和长期疗效。方法：86例成人ADHD患者随机分为iCBT联合用药组（iCBT+M, n = 43）和单纯用药组（n = 43）。iCBT+M组接受12周的iCBT治疗并持续用药，而仅用药组继续单独用药。主要结果是ADHD症状的改变。次要结局包括情绪症状、执行功能、生活质量和整体功能。评估基线、治疗后（T1）、6个月（T2）和12个月随访（T3）的结果。采用混合线性模型评估两组在每个随访点的结果差异。结果：与单纯用药组相比，iCBT+M组在ADHD症状（T1/T2时d = 0.50， T3时0.59）、执行功能（T1时d = 0.87， T2时0.49，T3时0.25）、生活质量（T1时d = -0.74， T2时-0.59，T3时-0.28）、整体功能（T1时d = 0.66， T2时0.85，T3时0.42）和焦虑（T1时d = 0.43）方面均有较大改善。结论：iCBT干预可能通过改善核心症状、执行功能、生活质量和整体功能而使服药的ADHD成人受益，效果持续12个月。

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引用次数: 0

Sleep and physical activity patterns in relation to daily-life symptoms in psychosis: An actigraphy and experience sampling study 睡眠和体力活动模式与精神病患者日常生活症状的关系：行为记录仪和经验取样研究。

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-02-01 DOI: 10.1016/j.psychres.2024.116320

Lydia E. Pieters , Jeroen Deenik , Adriaan W. Hoogendoorn , Eus J.W. van Someren , Peter N. van Harten

Sleep disturbances and reduced physical activity (PA) are important risk factors for poor physical and mental health outcomes in people with psychosis. However, the precise interrelations between sleep, PA and psychopathology remain unclear. This study combined experience sampling (ESM) and actigraphy in thirty-two patients with a schizophrenia spectrum disorder to investigate interrelations of day-to-day variations in actigraphic estimates of PA and sleep and psychotic and affective symptoms. Multilevel mixed-models show that subjects reported more positive affect on more physically active days. Unexpectedly, participants reported worse next-day negative affect and/or psychotic symptoms after nights with higher sleep continuity, as consistently indicated by sleep efficiency and the mean duration of bouts of wake and sleep. Lastly, PA was higher after nights with higher sleep continuity and shorter total sleep duration. These results highlight that modifiable lifestyle factors such as PA and sleep have an intricate, but clinically relevant relationship with psychotic and affective symptoms. Future studies are needed to further examine the complex effects of these behaviors in order to develop effective, targeted treatment strategies to improve clinical outcome in psychosis.

睡眠障碍和体力活动（PA）减少是导致精神病患者身心健康状况不佳的重要风险因素。然而，睡眠、体力活动和精神病理学之间的确切相互关系仍不清楚。这项研究结合了经验取样（ESM）和动量描记法，对32名精神分裂症谱系障碍患者进行了调查，以了解动量描记法估计的PA和睡眠的日间变化与精神病和情感症状之间的相互关系。多层次混合模型显示，受试者在身体活动较多的日子里会有更多的积极情绪。意想不到的是，在睡眠连续性较高的夜晚，受试者第二天的消极情绪和/或精神症状会更严重，这与睡眠效率和醒后睡眠的平均持续时间一致。最后，在睡眠连续性较高和总睡眠时间较短的夜晚，PA 值较高。这些结果突出表明，PA 和睡眠等可改变的生活方式因素与精神病症状和情感症状有着错综复杂的临床相关关系。未来的研究需要进一步研究这些行为的复杂影响，以便制定有效的、有针对性的治疗策略，改善精神病患者的临床疗效。

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引用次数: 0

The state of implementation science in major depressive disorder: A narrative review 重度抑郁症的实施科学现状：述评。

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-02-01 DOI: 10.1016/j.psychres.2024.116330

Yuru He , Jill K. Murphy , Xing Wang , Erin E. Michalak , Tao Yang , Xiaorui Yang , Jing Liu , Yiru Fang , Raymond W. Lam , Jun Chen

Major depressive disorder (MDD) is one of the most prevalent and disabling mental disorders with high recurrence rate. There is often a gap between scientific evidence related to the effective and cost-effective treatment of depression and clinical practice. Implementation science is a field of inquiry that aims to advance the process of applying evidence-based interventions to real-world problems. Implementation research consists of two broad phases. The first phase seeks to identify the gaps that exist between evidence and practice and their impact on outcomes. The second phase, building on the first, evaluates the effectiveness of implementation strategies by examining various implementation indicators to support the adoption and scale up of interventions. Although implementation research can facilitate the uptake and adoption of evidence-based interventions, it is underused in depression research. In this narrative review, the authors will introduce the definition of implementation science and the state of implementation science in MDD in order to support more widespread use of implementation science for scaling up evidence-based interventions.

重度抑郁症（MDD）是最常见、致残性精神障碍之一，复发率高。与有效和具有成本效益的抑郁症治疗有关的科学证据与临床实践之间往往存在差距。实施科学是一个探究领域，旨在推进将基于证据的干预措施应用于现实世界问题的过程。实施研究包括两个广泛的阶段。第一阶段旨在确定证据与实践之间存在的差距及其对结果的影响。第二阶段在第一阶段的基础上，通过审查各种实施指标来评估实施战略的有效性，以支持采取和扩大干预措施。尽管实施研究可以促进以证据为基础的干预措施的吸收和采用，但在抑郁症研究中尚未得到充分利用。在这篇叙述性综述中，作者将介绍实施科学的定义和MDD中实施科学的现状，以支持更广泛地使用实施科学来扩大基于证据的干预措施。

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