Psychiatry Research最新文献_第8页

SHAPING MINDS: A systematic review and meta-analysis on the effects of structured exercise in schizophrenia spectrum disorders 塑造心智：对精神分裂症谱系障碍中结构化锻炼效果的系统回顾和荟萃分析。

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-12-19 DOI: 10.1016/j.psychres.2025.116919

Elona Greca , Valentina Belalcazar-Vivas , Gerardo F. Ferrer , Jack J. Michel

Background: Individuals with schizophrenia spectrum disorders experience impairments across multiple domains, including cognition, quality of life, and social functioning. Structured exercise interventions may improve these outcomes. We hypothesised that aerobic and combined (aerobic plus resistance) exercise programs would enhance cognitive function, reduce symptom severity, and improve well-being. Study Design: A PRISMA-guided search of PubMed, EMBASE, PsycINFO, Web of Science, SciELO, and ClinicalTrials.gov (2009–2024) identified 17 randomized controlled trials. Standardized mean differences (SMDs) were pooled using a random-effects model. Subgroup analyses examined age and gender. Risk of bias was assessed using RoB 2, publication bias with Egger’s test, and certainty of evidence through GRADE.

Results: Structured exercise produced a moderate-to-large improvement in overall well-being (SMD = 0.68; 95% CI: 0.43–0.93; p < .001). Significant benefits were also observed in cognition (SMD = 0.59), symptom severity (SMD = 0.71), quality of life (SMD = 0.60), and social functioning (SMD = 0.55). Age and gender moderated treatment effects, with the strongest benefits in males and individuals aged 36–45. Sensitivity analyses confirmed the robustness of results. Mechanistic evidence suggests that improvements may be mediated through increased brain-derived neurotrophic factor (BDNF) and reduced inflammatory signaling.

Conclusions: Structured exercise is an effective adjunctive intervention for schizophrenia spectrum disorders, improving psychiatric and functional outcomes beyond standard care. Findings support the integration of personalized, scalable exercise programs within routine psychiatric treatment.

背景：精神分裂症谱系障碍患者会经历多个领域的损害，包括认知、生活质量和社会功能。有组织的运动干预可以改善这些结果。我们假设有氧和联合（有氧加抗阻）运动计划可以增强认知功能，降低症状严重程度，改善健康状况。研究设计：prism引导检索PubMed， EMBASE, PsycINFO, Web of Science， SciELO和ClinicalTrials.gov(2009-2024)，确定17个随机对照试验。标准化平均差异（SMDs）采用随机效应模型进行汇总。亚组分析检查了年龄和性别。偏倚风险评估采用RoB 2，发表偏倚采用Egger检验，证据确定性采用GRADE。结果：有组织的锻炼对整体幸福感产生了中等到较大的改善（SMD = 0.68; 95% CI: 0.43-0.93; p < 0.001）。在认知（SMD = 0.59）、症状严重程度（SMD = 0.71）、生活质量（SMD = 0.60）和社会功能（SMD = 0.55）方面也观察到显著的益处。年龄和性别调节了治疗效果，对男性和年龄在36-45岁之间的个体效果最好。敏感性分析证实了结果的稳健性。机制证据表明，改善可能通过增加脑源性神经营养因子（BDNF）和减少炎症信号传导介导。结论：有组织的锻炼是一种有效的精神分裂症谱系障碍辅助干预，可以改善标准治疗之外的精神和功能结局。研究结果支持将个性化的、可扩展的锻炼计划整合到常规精神治疗中。

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引用次数: 0

Clinical and neurobiological effects of real-life and virtual animal-assisted interventions for patients with depression 现实生活和虚拟动物辅助干预对抑郁症患者的临床和神经生物学影响。

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-12-19 DOI: 10.1016/j.psychres.2025.116917

Julien Willms, Alice Sader, Georg Juckel, Paraskevi Mavrogiorgou

Background

Animal-assisted interventions (AAIs) have been shown to exert beneficial effects on various mental disorders. However, organizational, hygienic, and ethical challenges often limit their implementation. As a result, virtual alternatives are gaining increasing relevance. Initial findings suggest that digital interactions with animals may also elicit affective and physiological responses, although systematic, controlled studies are lacking. This study aimed to systematically compare the effects of real and virtual AAIs on depressive symptoms and peripheral oxytocin concentrations in patients with depression and healthy controls.

Methods

In a mixed factorial design (N = 66), patients with depression and healthy controls each underwent three conditions in randomized order: interaction with a live therapy dog, a virtual therapy dog, and a virtual reality (VR)-based fantastical creature. Depressive symptoms (per the DASS) and salivary oxytocin concentrations were assessed.

Results

All interventions significantly reduced depressive symptoms in patients, with the strongest effects observed for the live therapy dog and the VR-based fantastical creature. Oxytocin levels increased significantly across all conditions, regardless of participant group.

Conclusion

Virtual animal interactions can evoke psychophysiological effects comparable to real-life AAIs. They appear promising as accessible, technology-supported interventions for psychiatric populations, particularly when access to live animals is limited.

背景：动物辅助干预（AAIs）已被证明对各种精神障碍发挥有益作用。然而，组织、卫生和道德方面的挑战往往限制了它们的实施。因此，虚拟替代方案正获得越来越多的相关性。初步研究结果表明，与动物的数字互动也可能引起情感和生理反应，尽管缺乏系统的对照研究。本研究旨在系统比较真实和虚拟AAIs对抑郁症患者和健康对照者抑郁症状和外周催产素浓度的影响。方法：在混合因子设计（N = 66）中，抑郁症患者和健康对照者按随机顺序分别接受三种情况：与一只活治疗犬、一只虚拟治疗犬和一个基于虚拟现实（VR）的幻想生物互动。评估抑郁症状（根据DASS）和唾液催产素浓度。结果：所有干预措施都能显著减轻患者的抑郁症状，其中对活治疗犬和基于vr的幻想生物的效果最强。催产素水平在所有情况下都显著增加，与参与者组无关。结论：虚拟动物互动可以引起与现实生活中的人工智能相当的心理生理效应。它们看起来很有希望成为精神病患者可获得的、技术支持的干预措施，特别是在获得活体动物的机会有限的情况下。

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引用次数: 0

Orthorexia nervosa through the eyes of psychiatrists: A large population study 精神病学家眼中的神经性厌食症：一项大规模人口研究。

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-12-18 DOI: 10.1016/j.psychres.2025.116916

Ibrahim Halil Akbas , Selman Yildirim , Omca Guney , Oguz Peker , Beyza Yildirim , Anna Brytek-Matera

Orthorexia nervosa (ON), characterized by an obsessive focus on healthy eating and rigid dietary rules, is not yet recognized in major diagnostic systems such as the DSM-5-TR or ICD-11. Although healthcare professionals-especially those in dietetics-show elevated rates of orthorexic tendencies, the perspectives of psychiatrists, who play a key role in diagnosis and treatment, remain largely unexplored. This study aimed to assess Turkish psychiatrists’ knowledge, attitudes, and clinical experiences regarding ON, as well as their own orthorexic tendencies. A cross-sectional online survey was conducted among adult and child-adolescent psychiatrists in Türkiye. The survey included demographic questions, items on knowledge and attitudes toward ON, clinical experience with ON symptoms, and the Orthorexia Nervosa Inventory (ONI). A total of 1067 psychiatrists completed the questionnaire. Although 84.5% of participants had heard of ON, only 13% rated their knowledge as “good” or “very good.” The prevalence of ON symptomatology (ONI ≥72) was 0.28%. Psychiatrists commonly associated ON with obsessive-compulsive and eating disorders, but only half supported its inclusion in diagnostic manuals. Key challenges in clinical recognition included a lack of clear criteria and significant symptom overlap with other disorders. Psychotherapy was the most recommended treatment, though difficulties with patient adherence were frequently reported. Despite growing awareness, ON remains poorly understood and inconsistently conceptualized among Turkish psychiatrists. The findings underscore a critical need for standardised diagnostic criteria, clearer clinical definitions, and the integration of ON into psychiatric education and training. Developing consensus-based guidelines may improve recognition, diagnosis, and management of ON in clinical settings.

神经性正食症（Orthorexia neurosa， ON）的特点是过分注重健康饮食和严格的饮食规则，目前尚未在主要诊断系统（如DSM-5-TR或ICD-11）中得到认可。尽管医疗保健专业人士——尤其是营养学专业人士——显示出正统厌食症倾向的比例上升，但在诊断和治疗中起关键作用的精神科医生的观点在很大程度上仍未得到探索。本研究旨在评估土耳其精神科医生对ON的知识、态度和临床经验，以及他们自己的正畸倾向。一项横断面在线调查在成人和儿童青少年精神科医生在 rkiye。调查内容包括人口统计问题、on的知识和态度、on症状的临床经历和神经性正畸量表（ONI）。共有1067名精神病医生完成了问卷调查。尽管84.5%的参与者听说过ON，但只有13%的人认为他们的知识“好”或“非常好”。ON症状（ONI≥72）的患病率为0.28%。精神病学家通常将ON与强迫症和饮食失调联系起来，但只有一半的人支持将其纳入诊断手册。临床识别的主要挑战包括缺乏明确的标准和与其他疾病的显著症状重叠。心理治疗是最推荐的治疗方法，尽管患者坚持治疗的困难经常被报道。尽管越来越多的人意识到，但在土耳其精神科医生中，对ON的理解仍然很差，概念化也不一致。研究结果强调了对标准化诊断标准、更清晰的临床定义以及将ON纳入精神病学教育和培训的迫切需要。制定基于共识的指南可以改善临床环境中ON的识别、诊断和管理。

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引用次数: 0

“Home is where my toothbrush is”: An occupational therapy perspective of trauma and PTSD following October 7th and the Iron Swords War “牙刷在哪里，家就在哪里”：从职业治疗的角度看10月7日和铁剑战争后的创伤和创伤后应激障碍。

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-12-18 DOI: 10.1016/j.psychres.2025.116918

Moran Shaham Levy, Dorit Loew Goldberg

This article explores the contribution of occupational therapy (OT) to trauma care in the aftermath of the October 7th attacks and the Iron Swords War, with a focus on post-traumatic stress disorder (PTSD). It examines how traumatic experiences disrupt occupational identity, daily routines, and overall functioning. Drawing on trauma-informed care principles, the paper outlines OT-based interventions that promote recovery by facilitating engagement in meaningful activities that restore agency, coherence, and purpose. Clinical case examples illustrate the therapeutic role of occupation in stabilizing individuals and supporting identity reconstruction. The findings underscore OT’s integrative approach - linking person, environment, and occupation - as a vital component in interdisciplinary trauma recovery and posttraumatic growth.

本文探讨了职业疗法（OT）在“10·7”恐怖袭击和“铁剑战争”后的创伤护理中的贡献，重点是创伤后应激障碍（PTSD）。它研究了创伤性经历是如何破坏职业身份、日常生活和整体功能的。根据创伤知情护理原则，本文概述了基于创伤治疗的干预措施，通过促进参与有意义的活动来恢复能动性、连贯性和目的，从而促进康复。临床案例说明了职业在稳定个体和支持身份重建方面的治疗作用。研究结果强调了OT的综合方法——将人、环境和职业联系起来——作为跨学科创伤恢复和创伤后成长的重要组成部分。

引用次数: 0

Unraveling the gender divide: A systematic review of gender-specific differences at the first episode of psychosis 揭开性别鸿沟：对精神病首发期性别差异的系统回顾

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-12-18 DOI: 10.1016/j.psychres.2025.116914

Giulia Santangelo , Martina Gnazzo , Valentina Baldini , Diana De Ronchi , Marco Carotenuto , Andrea Fiorillo , Armando D’Agostino

This systematic review aims to explore gender differences in the first episode of psychosis (FEP) among individuals aged 13 to 24 years, focusing on clinical, demographic, and outcomecharacteristics, with an emphasis on how gender-related differences in symptom presentation maycontribute to misdiagnosis, particularly among females. A comprehensive search was conducted across PubMed, Embase, and PsycInfo databases, targetingstudies published between 2014 and 2024. Inclusion criteria were observational and experimentalstudies reporting gender-disaggregated data on the FEP in adolescents and young adults aged 13 to24 years. The screening and selection process followed a systematic approach, and data wereextracted focusing on gender-based differences in onset, clinical presentation, and outcomes ofpsychosis. The final section comprised six studies involving 3798 individuals with a diagnosis of FEP. Thefindings highlighted a later onset of psychosis in females, along with a more affective and atypicalsymptom presentation compared to males, who exhibited more overt psychotic features. Femaleswere more frequently misdiagnosed with mood disorders before receiving a correct psychosisdiagnosis, contributing to delayed interventions. Despite better short-term treatment responses inwomen, they showed higher vulnerability to relapse, particularly in hormonally sensitive periods. The differences in clinical presentation between males and females in FEP may contribute to highermisdiagnosis rates in women. By examining these gender differences, this review highlights theneed for more accurate diagnostic criteria and tailored interventions for both genders, which couldimprove early intervention.

本系统综述旨在探讨13至24岁个体首次精神病发作（FEP）的性别差异，重点关注临床，人口统计学和结局特征，重点关注症状表现的性别相关差异如何导致误诊，特别是在女性中。在PubMed、Embase和PsycInfo数据库中进行了全面的搜索，目标是2014年至2024年之间发表的研究。纳入标准是观察性和实验性研究，报告了13至24岁青少年和年轻人FEP的性别分类数据。筛选和选择过程遵循系统的方法，提取的数据侧重于基于性别的精神病发病、临床表现和结果的差异。最后一部分包括6项研究，涉及3798名诊断为FEP的个体。研究结果强调，与男性相比，女性精神病发病较晚，而且症状表现更有情感性和非典型，男性表现出更多明显的精神病特征。在得到正确的精神病诊断之前，女性更容易被误诊为情绪障碍，导致干预延迟。尽管女性的短期治疗效果更好，但她们更容易复发，尤其是在激素敏感期。男性和女性在FEP临床表现上的差异可能导致女性较高的误诊率。通过检查这些性别差异，本综述强调需要更准确的诊断标准和针对两性的量身定制的干预措施，这可以改善早期干预。

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引用次数: 0

Magnetoencephalography during a saccadic eye movement task in anorexia nervosa 神经性厌食症跳跃性眼动任务中的脑磁图。

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-12-18 DOI: 10.1016/j.psychres.2025.116915

Andrea Phillipou , Larry A Abel , Susan L Rossell , Caroline Gurvich , David J Castle , Rachel Oliver (Batty) , William Woods

引用次数: 0

Categories, symptom characteristics and factors influencing depression and anxiety in pregnant women: latent profile analysis and network analysis 孕妇抑郁、焦虑的类别、症状特征及影响因素：潜在剖面分析与网络分析

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-12-17 DOI: 10.1016/j.psychres.2025.116912

Haiyan Liu , Youjing Kong , Xiuyun Cao , Jingjing Liu , Rufang Zhou , Qianzhi Lin , Wenting Liu , Yu Chen

Comorbid prenatal depression and anxiety are prevalent among pregnant women and pose significant risks to maternal and infant health. Previous research has focused on linear associations between depression and anxiety among pregnant women, with limited exploration of subgroup characteristics and symptom heterogeneity. This study examines the categories, symptom characteristics and factors influencing depression and anxiety in pregnant women via latent profile analysis and network analysis. A cross-sectional survey was conducted from June 2021 to August 2023 at hospital obstetric clinics in Guangzhou and Zhongshan, Guangdong Province. A total of 1683 pregnant women completed the Edinburgh Postpartum Depression Scale, the seven-item Generalized Anxiety Disorder Scale, the Cognitive Fusion Questionnaire-Fusion, the Simplified Coping Style Questionnaire and the General Function of Family Assessment Device. Subgroups of patients with depression and anxiety symptoms were identified through latent profile analysis. Multiple regression and network analyses were used to reveal subgroup characteristics. The participants were divided into three subgroups: low depression and anxiety symptom groups (n = 809, 48.07%), medium depression and anxiety symptom groups (n = 756, 44.92%), and high depression and anxiety symptom groups (n = 118, 7.01%). There were significant differences among these three subgroups in terms of age, positive coping, negative coping, cognitive fusion, and family function. The core symptoms of the low and moderate depression and anxiety symptom groups were "sad or miserable" and "anxious or worried", whereas those of the high depression and anxiety symptom group were "crying" and "uncontrollable worry". Our study highlights the need for stratified interventions tailored to symptom severity and subgroup characteristics.

产前抑郁和焦虑的合并症在孕妇中普遍存在，对母婴健康构成重大风险。先前的研究主要集中在孕妇抑郁和焦虑之间的线性关系，对亚组特征和症状异质性的探索有限。本研究通过潜在特征分析和网络分析，探讨孕妇抑郁、焦虑的类别、症状特征及影响因素。横断面调查于2021年6月至2023年8月在广东省广州和中山市的医院产科诊所进行。1683名孕妇完成了爱丁堡产后抑郁量表、七项广泛性焦虑障碍量表、认知融合问卷-融合、简化应对方式问卷和家庭评估装置的一般功能。通过潜在特征分析确定抑郁和焦虑症状患者的亚组。采用多元回归和网络分析揭示亚群特征。将受试者分为低抑郁焦虑症状组（809人，48.07%）、中度抑郁焦虑症状组（756人，44.92%）、高抑郁焦虑症状组（118人，7.01%）3个亚组。三个亚组在年龄、积极应对、消极应对、认知融合、家庭功能等方面存在显著差异。低、中度抑郁焦虑症状组的核心症状为“悲伤或痛苦”和“焦虑或担心”，高抑郁焦虑症状组的核心症状为“哭泣”和“无法控制的担忧”。我们的研究强调了针对症状严重程度和亚组特征进行分层干预的必要性。

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引用次数: 0

Single fixed-dose intranasal racemic ketamine treatment for the treatment of acute suicidality in a transdiagnostic patient population: Results of a pilot study 单次鼻内固定剂量外消旋氯胺酮治疗跨诊断患者的急性自杀：一项初步研究的结果。

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-12-16 DOI: 10.1016/j.psychres.2025.116909

Gijsbrecht H.J. Roelandt , Jurriaan F.M. Strous , Radboud M. Marijnissen , Jeanine Kamphuis , Jens. H. van Dalfsen , Robert A. Schoevers

Aims

Ketamine has been shown to decrease suicidality in patients with depression. However, little is known about tolerability and efficacy in heterogenous, acutely suicidal patients in emergency settings. This pilot study aimed to assess the feasibility, acceptability, and safety of generic intranasal racemic ketamine (75 mg) in the treatment of acute suicidality regardless of the underlying diagnosis, as preparation for a subsequent double-blind randomized placebo-controlled trial (RCT).

Method

From September 2021 to June 2022, 12 patients with acute suicidality were recruited. All received a single open-label dose of 75 mg intranasal racemic ketamine. Suicidality was assessed with the Beck Scale for Suicidal Ideation (BSSI), depression with the Montgomery-Åsberg Depression Rating Scale (MADRS), side effects with the Systematic Assessment for Treatment Emergent Effects (SAFTEE) and Clinician Administered Dissociative Symptom Scale (CADSS), and overall improvement with the Clinical Global Impression (CGI) at 60 min, 180 min, and at 1, 3, and 7 days post-treatment. The CADSS and SAFTEE were administered only at baseline, 60 and 180 min post intervention. Vital signs were monitored for the first 240 min post intervention. Optional blood sampling occurred at baseline and 180 min post-treatment, and Magnetic Resonance Imaging one day post intervention.

Results

Treatment was well-tolerated. We observed a downward trend in both BSSI and MADRS scores one day post treatment, though this effect declined by day seven. One patient developed ketamine misuse several weeks after participation.

Conclusions

The treatment was generally feasible, well-tolerated and safe. Intranasal ketamine reduced acute suicidality in some cases but regarding efficacy, no definitive conclusions can be drawn from this pilot study. Amendments were made to the study protocol with extended follow-up time, investigation of drug liking and craving, less questionnaires and longer inclusion window.

目的：氯胺酮已被证明可以降低抑郁症患者的自杀率。然而，对于异质急性自杀患者在急诊环境中的耐受性和疗效知之甚少。本初步研究旨在评估通用鼻内消旋氯胺酮（75mg）治疗急性自杀的可行性、可接受性和安全性，而不考虑潜在的诊断，为随后的双盲随机安慰剂对照试验（RCT）做准备。方法：从2021年9月至2022年6月，招募12例急性自杀患者。所有患者均接受单次开放标签剂量75mg鼻内消旋氯胺酮。采用贝克自杀意念量表（BSSI）评估自杀倾向，采用蒙哥马利-Åsberg抑郁评定量表（MADRS）评估抑郁，采用治疗突发效应系统评估（SAFTEE）和临床医生管理的解离症状量表（CADSS）评估副作用，并在治疗后60分钟、180分钟、1、3和7天采用临床总体印象量表（CGI）评估总体改善情况。CADSS和SAFTEE仅在干预后的基线、60和180分钟进行。干预后240分钟监测生命体征。在基线和治疗后180分钟进行选择性采血，并在干预后1天进行磁共振成像。结果：治疗耐受性良好。我们观察到BSSI和MADRS评分在治疗后一天呈下降趋势，尽管这种影响在第7天下降。一名患者在参与几周后出现氯胺酮滥用。结论：治疗总体可行、耐受性好、安全。鼻内氯胺酮在某些情况下降低了急性自杀率，但关于疗效，从这项初步研究中无法得出明确的结论。对研究方案进行了修改，延长了随访时间，调查了药物喜好和渴望，减少了问卷，延长了纳入窗口。

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引用次数: 0

Perinatal depression during armed conflict in Israel: Mental health risks and challenges, a cross-sectional study 以色列武装冲突期间的围产期抑郁症：心理健康风险和挑战，一项横断面研究。

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-12-16 DOI: 10.1016/j.psychres.2025.116910

Samira Alfayumi-Zeadna , Vered Bar , Galit Neufeld-kroszynski , Inbal Reuveni , Vered Maugami , Rena Bina

Background

The recent armed conflict between Israel and Hamas (October 7,2023) has impacted various populations, including perinatal women, whose mental health can be particularly vulnerable to deterioration during periods of conflict. This study aimed to assess the prevalence of perinatal depression symptoms (PNDs) during the war and identified related risk factors for PNDs.

Methods

This cross-sectional study included 862 women who were pregnant or up to 12 months postpartum. Participants filled out an online self-report questionnaire. PNDs were measured using the Edinburgh Postnatal Depression Scale (EPDS). Bivariate analyses (t-tests, χ² tests) were performed to examine associations between demographic, socioeconomic, and post-traumatic stress disorder (PTSD) symptoms and war-related variables, and PND. Multivariable logistic regression was used to identify independent risk factors for PND symptoms (EPDS ≥10).

Results

The prevalence of PNDs was 32.7 %, with an EPDS score of 10 or higher. Suicidal thoughts were reported by 8 % of participants and PTSD was reported by 30 %. Statistically significant associations were found between PNDs and posttraumatic stress disorder, with women who experienced PTSD being 2.5 times more likely to report PNDs. Other factors associated with increased risk of PNDs included loneliness, pregnancy status (pregnant women were 1.5 times more likely to report PNDs, reduction of family income due to the war, war-related property damage, and history of mental health diseases.

Conclusion

The findings demonstrate the severe impact of the war on the mental health of perinatal women, highlighting the need for provision of targeted mental health support during and after conflict situations to mitigate these adverse effects.

背景：最近以色列和哈马斯之间的武装冲突（2023年10月7日）影响了各种人群，包括围产期妇女，她们的心理健康在冲突期间特别容易恶化。本研究旨在评估战争期间围产期抑郁症状（PNDs）的患病率，并确定PNDs的相关危险因素。方法：这项横断面研究包括862名怀孕或产后12个月的妇女。参与者填写了一份在线自我报告问卷。pnd采用爱丁堡产后抑郁量表（EPDS）进行测量。采用双变量分析（t检验、χ 2检验）检验人口统计学、社会经济、创伤后应激障碍（PTSD）症状和战争相关变量与PND之间的关联。采用多变量logistic回归确定PND症状的独立危险因素（EPDS≥10）。结果：pnd患病率为32.7%，EPDS评分在10分及以上。8%的参与者报告有自杀念头，30%报告有创伤后应激障碍。统计上发现pnd与创伤后应激障碍之间存在显著的关联，经历过PTSD的女性报告pnd的可能性是创伤后应激障碍的2.5倍。与PNDs风险增加相关的其他因素包括孤独、怀孕状况（孕妇报告PNDs的可能性高出1.5倍）、战争导致的家庭收入减少、与战争有关的财产损失以及精神疾病史。结论：调查结果表明，战争对围产期妇女的心理健康造成严重影响，强调需要在冲突期间和冲突后提供有针对性的心理健康支持，以减轻这些不利影响。

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引用次数: 0

Efficacy of glutamate-GABA modulator riluzole for the treatment of cognitive and psychotic symptoms in 22q11.2 deletion syndrome: A placebo-controlled crossover trial 谷氨酸- gaba调节剂利鲁唑治疗22q11.2缺失综合征认知和精神病症状的疗效：一项安慰剂对照交叉试验

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-12-16 DOI: 10.1016/j.psychres.2025.116913

Amy L Sylvester , Jeltje CC Spapens , Nele Soons , Sophie Kappert , Paddy Janssen , Dimo Ivanov , Janneke R Zinkstok , David EJ Linden , Thérèse van Amelsvoort , Claudia Vingerhoets

Individuals with 22q11.2 deletion syndrome are susceptible to psychosis and cognitive impairments. These symptoms have been linked to a disruption in the balance of glutamate (excitatory) to GABA (inhibitory) transmission. This clinical trial aimed to determine whether the glutamate and GABA-modulating drug riluzole reduces psychotic or cognitive symptoms within 22q11.2 deletion syndrome. 32 participants with a 22q11.2 deletion and psychotic and/or cognitive symptoms were enrolled in this placebo-controlled, fixed-order crossover trial. Participants received placebo for 8 weeks, followed by 8 weeks of 100mg/day riluzole. The Positive and Negative Syndrome Scale (PANSS) and Pennsylvania Computerized Neurocognitive Battery (CNB) were used to assess psychotic and cognitive symptoms, with PANSS total and subscale scores and CNB accuracy and reaction time as primary outcome measures. Correcting for family-wise error rate, riluzole improved performance on executive function (p = 0.036), social cognition (p = 0.041), and non-verbal reasoning (p = 0.005) tasks in comparison to baseline. Following correction, no significant effects of riluzole were found on the PANSS total score and subscales, or on accuracy and reaction time on the CNB compared to placebo. Exploratory analyses of individual PANSS items indicated that riluzole reduced anxiety (p = 0.001) and impairments in abstract thinking (p = 0.039) compared to baseline. Our results suggest riluzole may have beneficial effects on mental health and cognition. Further research is needed to confirm these findings and establish a responsive phenotype.

患有22q11.2缺失综合征的个体易患精神病和认知障碍。这些症状与谷氨酸（兴奋性）与GABA（抑制性）传递平衡的破坏有关。本临床试验旨在确定谷氨酸和gaba调节药物利鲁唑是否能减轻22q11.2缺失综合征的精神病或认知症状。这项安慰剂对照、固定顺序的交叉试验纳入了32名22q11.2缺失并伴有精神病和/或认知症状的受试者。参与者接受安慰剂治疗8周，随后8周服用100mg/天的利鲁唑。采用阳性和阴性综合征量表（PANSS）和宾夕法尼亚计算机化神经认知电池（CNB）评估精神病和认知症状，以PANSS总分和亚量表评分以及CNB准确性和反应时间作为主要结局指标。与基线相比，利鲁唑改善了执行功能（p = 0.036）、社会认知（p = 0.041）和非语言推理（p = 0.005）任务的表现，纠正了家庭错误率。校正后，与安慰剂相比，利鲁唑对PANSS总分和亚量表，或对CNB的准确性和反应时间没有显著影响。个体PANSS项目的探索性分析表明，与基线相比，利鲁唑减少了焦虑（p = 0.001）和抽象思维障碍（p = 0.039）。我们的研究结果表明利鲁唑可能对心理健康和认知有有益的影响。需要进一步的研究来证实这些发现并建立响应表型。

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引用次数: 0