Psychiatry and Clinical Psychopharmacology最新文献

Background: : This study from Istanbul aimed to compare the child and adolescent psychiatric admissions and diagnosis rates between the first 3 months of the pandemic, the previous 3 months in the same year, and the same months in the previous year.

Methods: : Children and adolescents were grouped according to the admission dates. Group A, between March 11 and June 1, 2020; Group B, between January 1 and March 11, 2020; and Group C, between March 11 and June 1, 2019. Only clinical interviews and diagnoses according to Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) interview were included.

Results: : Autism spectrum disorder (ASD), obsessive-compulsive disorder (OCD)/tic disorder, and intellectual disability (ID) diagnoses were higher in group A than in groups B and C (for ASD, 6.4%, 4.3%, and 3.6%; for OCD/tic disorder, 2.9%, 1.8%, 1.7%; for ID, 3.7%, 2.5%, and 2.1%, respectively) (P < .001). Attention-deficit hyperactivity disorder (ADHD) diagnosis was higher in group A than in only group B (59.8% and 49.7%, respectively) (P < 0.001). Depression was higher in group A than in only group C (4.1% and 2.2%, respectively) (P < .001). Conduct disorder (CD) diagnosis was lower in group A than in only group B (3.6% and 6.4%, respectively) (P < .05).

Conclusion: : Child psychiatry diagnosis rates were found to change significantly during the initial phase of the pandemic period. Among the referrals, ASD, OCD, Tic disorder, ID, ADHD, and depression admissions were significantly higher. The rate of pediatric neurodevelopmental disorders, particularly ASD, increased during the initial phase of the COVID-19 pandemic.

Background: Our study aimed to investigate the factors associated with mothers' shaking behavior of their babies.

Methods: Sixty-three mothers who stated that they shook their babies (Group B) and 91 mothers who stated that they did not (Group A) among those who applied to or were followed up from the Pediatric Outpatient Clinics of our University Hospital were included. The mothers (with a baby aged 0-30 months) completed the Brief Symptom Inventory (BSI) and psychiatric rating scales measuring attachment styles, empathic tendency, perceived social support, and self-esteem. The severity of the simulated shaking of the mothers was measured by an accelerometer placed on an infant manikin and separately scored on a Numerical Rating Scale by the researchers and an Illustrated Numeric Rating Scale by the mothers.

Results: In group B, babies' crying frequency was higher (P = .008); soothing the babies when they cried was more difficult (P = .019), mothers reported that they were exposed to physical violence more in their childhood (P = .003), BSI hostility scores (P = .004) and BSI-anxiety scores (P = .034) of the mothers were higher when compared with the group A. The age of the babies (P = .002, OR = 1.096), moderate crying frequency (P = .035, OR = 2.900), the mothers' difficulty in soothing their babies (sometimes P = .018, OR = 3.705, often/always P = .014, OR = 7.777), and the mothers' experience of physical violence in childhood (P = .002, OR = 5.674) were found to be factors affecting the shaking behavior.

Conclusion: Clarifying the factors associated with the mothers' shaking behavior of their babies would be helpful in terms of protecting future generations.

Background: It is to examine how child psychiatry admissions, diagnosis and treatment trends in the second wave (September-December 2020/SD20) of the coronavirus disease 2019 (COVID-19) pandemic change compared to the pre-pandemic (SD19) and the first wave (March-June 2020/MJ20).

Methods: Our study was planned as a multicenter, retrospective cross-sectional. Data were obtained from hospital computer systems databases. All patients admitted to the child psychiatry clinic on SD19 and SD20 constituted the study sample. In total, 5244 admissions were assessed.

Results: Of the admissions, 1459 were repeat exams, and 3785 were cases. 50.9% (n = 1927) of the cases came in SD19 and 49.1% (n = 1858) in SD20. In 2019, 37% (n = 825) of cases were girls, compared to 41.6% (n = 646) in 2020 (P = .004). The mean age of those who came in 2019 was 9.61 ± 4.08; The mean age of those who came in 2020 was 10.15 ± 5.38 (P = .002). In 2020, oppositional defiant conduct disorder, major depressive disorder, social anxiety disorder, obsessive-compulsive disorder, sleep-wake disorder, and dysthymia were significantly higher, while specific learning disorders, separation anxiety disorder, and intellectual disability were found to be lower.

Conclusion: The decrease in second-wave admissions is less than in the first wave. In the second wave, externalizing and internalizing problems have increased. Drug therapy was prioritized. Postponing admissions was less in the second wave.

Background: Psychological resilience is defined as the resilience capacity and the power to recover in the face of stressful life events. Adolescents in institutional care have different individual, familial, and environmental risk factors that negatively affect their psychological resilience. This study aimed to comparatively examine studies that detect the risk factors affecting the resilience of adolescents living in institutional care and make recommendations regarding initiatives or specific outcomes related to this.

Methods: This study systematically reviewed national and international literature databases such as PubMed, Web of Science, Science Direct, Medline, CINAHL, EBSCO host, Psychinfo, Cochrane Library, Turkish Ulakbim, Turkish Medical Directory, and Turkish Psychiatry Directory up to December 2021. Fourteen studies were included in this study.

Results: Many significant risk factors, such as adolescents' interpersonal relationships, self-confidence, self-esteem, self-efficacy levels, problem-solving skills, empathy skills, as well as parental abandonment, domestic violence, socioeconomic poverty, a history of abuse, peer rejection, lack of social support resources, and low academic performance, have been identified and discussed at individual, familial, and environmental levels.

Conclusion: Adolescents in institutional care were more vulnerable and had more mental and behavioral problems than their peers. This systematic review found no studies evaluating preventive programs, interventions, or interventions designed to reduce the frequency and prevalence of future adverse events for children growing up in institutional care settings. Recommends the comprehensive inclusion and evaluation of preventive programs, practices, and assessments aimed at reducing the frequency and prevalence of risk factors affecting resilience.

Background: Childhood maltreatment has great impact on physical and mental health. This study was designed to investigate the relationship between childhood maltreatment experience, social support, Anxiety and Depression, and traumatic stress symptoms in adults.

Methods: There were 113 subjects aged 20-35 recruited. They filled out self-reported questionnaires, including the Childhood Trauma Questionnaire Short Form (CTQ-SF), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), International Trauma Questionnaire (ITQ), Chinese version of the PTSD Checklist for DSM-5 (PCL-5), and Multidimensional Scale of Perceived Social Support (MSPSS), to measure symptom severity regarding childhood maltreatment, Anxiety and Depression, post-traumatic stress/complex post-traumatic stress symptoms (PTSD/CPTSD), and social support. The symptom severity was compared between maltreatment and non-maltreatment groups. Regression and mediator analyzes were done to investigate the relationship between maltreatment experience, mental impact severity, and the role of social support.

Results: There were 74.3% of participants who had been maltreated as children. Those who experienced maltreatment had more PTSD/CPTSD symptom severity than those who did not. Family support, but not friend support, mediated the relationship between maltreatment and PTSD/CPTSD symptom severity.

Conclusion: Childhood maltreatment was associated with Anxiety and Depression and CPTSD symptom severity in young adults. Future prospective studies are warranted to investigate the role of family support in preventing consequences after maltreatment.

Background: To explore the mediating effect of smartphone addiction between psychological resilience and insomnia among university students.

Methods: This study included 581 clinical medical students from the Dalian Medical University, enrolled between September 2020 and May 2023. The Smartphone Addiction Scale (SAS-SV), Insomnia Severity Index (ISI), and Connor-Davidson Resilience Scale (CD-RISC) were used to assess smartphone addiction, insomnia, and psychological resilience among the students. The Process macro and Bootstrap methods were employed to analyze the mediating effect of smartphone addiction between psychological resilience and insomnia.

Results: The detection rate of smartphone addiction was 28.06% (163/581), and the detection rate of insomnia was 26.17% (152/581). The total SAS-SV score was 27.60 ± 14.27, the total ISI score was 6.60 ± 5.33, and the total CD-RISC score was 72.86 ± 6.88. There was a significant negative correlation between the total CD-RISC score and the total SAS-SV score (r = -0.4129, P < .0001), and a significant negative correlation between the total CD-RISC score and the total ISI score (r = -2.942, P < .0001). The total SAS-SV score and the total ISI score were significantly positively correlated (r = 0.5687, P < .0001). Psychological resilience was used as the independent variable, insomnia as the dependent variable, and smartphone addiction as the mediating variable in the mediation effect analysis. Psychological resilience negatively predicted insomnia (β = -0.0940, P < .0001), smartphone addiction positively predicted insomnia (β = 0.1564, P < .0001), and smartphone addiction mediated the relationship between psychological resilience and insomnia (effect value = -0.1339, 95% CI: -0.1680 to -0.1034), with an effect size of 58.75%.

Conclusion: Psychological resilience directly affects insomnia and also indirectly affects insomnia through the mediating effect of smartphone addiction.

Ekbom's syndrome (ES), also referred to as delusional parasitosis, is a psychiatric disorder that is relatively uncommon. It is characterized by a robust and unwavering belief in infestation despite the absence of predominant hallucinations or formal thought disorders. Ekbom syndrome presents in 2 main forms: primary, marked by delusions and abnormal tactile sensations; and secondary, where symptoms arise due to another underlying organic condition. In primary ES, the therapeutic approach primarily relies on antipsychotic (AP) medications. This article presents a case with primary ES showing that atypical APs with aripiprazole and brexpiprazole effectively treat this disease. Brexpiprazole, compared to aripiprazole, induced less tremor and akathisia in the case report, suggesting it might be more suitable for treating this condition.

Background: This study aims to examine leptin and ghrelin gene polymorphisms and serum levels in children with autism spectrum disorder (ASD).

Methods: The study comprised a case group of 40 children aged 2-7 diagnosed with ASD and a control group of 40 healthy children. The severity of ASD symptoms was assessed using the Childhood Autism Rating Scale and the Autism Behavior Checklist. Leptin and ghrelin gene variants were genotyped using polymerase chain reaction (PCR) restriction fragment length polymorphism (RFLP) methods. Serum ghrelin and leptin levels were measured using enzyme-linked immunosorbent assay kits.

Results: In this study, gene polymorphisms and allele frequencies were examined, and no significant difference was found (P > .05 for all). Our findings indicated no significant difference in leptin serum levels between the groups (P = .584). However, ghrelin serum levels were significantly lower in the ASD group (P = .027). Receiver operating curve analysis to determine the cutoff value of serum ghrelin level as a diagnostic indicator for ASD resulted in a cutoff value of 885.7 pg/mL with 42.50% sensitivity and 85% specificity (P = .021). No significant relationship was found between leptin and ghrelin serum levels and the severity of ASD (P > .05 for all).

Conclusion: Our study is the first to evaluate leptin and ghrelin gene polymorphisms in ASD. Our findings indicate no association between leptin and ghrelin gene polymorphisms and ASD. However, our study suggests that ghrelin serum levels may potentially contribute to the etiology of ASD. More research is needed to understand the role of leptin and ghrelin in ASD.

This article examines the relationship between patent foramen ovale (PFO) and migraine, emphasizing the mechanisms underlying the connection and the historical status of transcatheter PFO closure as a treatment for migraine. Patent foramen ovale is the most prevalent congenital cardiac defect in adults and frequently co-occurs with migraine, particularly migraine with aura. This article reviews several studies that have identified a significant prevalence of PFO in patients with migraine, implying that PFO and migraine may be more closely associated than previously thought. The underlying mechanisms of this association involve the transfer of emboli from the venous system to systemic circulation through the PFO, which can result in a range of clinical conditions. Transcatheter PFO closure therapy has demonstrated benefits in some patients with migraine; however, additional research is required to determine its effectiveness and safety. This article offers a comprehensive review of the current understanding of the link between PFO and migraine and emphasizes the need for further research in this field.

Background: The aim of this study was to compare the complete blood cell count parameters of patients with methamphetamine and synthetic cannabis use disorder (MCUD), a condition that has recently exhibited a gradual increase in prevalence, with those of healthy subjects.

Methods: In total, 76 patients diagnosed with MCUD and 78 healthy controls were included in the study. Venous blood samples were collected from all participants at presentation for laboratory examination.

Results: The rate of mono- and poly-substance users in the patient group was 14.5% and 85.5%, respectively. The average duration of methamphetamine (METH) use in the patient group is 3.0 ± 1.9 years. White blood cell (P < .001), PLT (P = .005), monocyte count (P < .001), basophil count (P < .001), neutrophil count (P < .001), lymphocyte count (P < .001) basophil/lymphocyte ratio (BLR) (P = .04), SII (P = .006), and SIRI (P = .001) values were significantly higher. In contrast Hgb (P = .043), Hct (P = .002), monocyte percentage (P = .004), and RBC (P = .021) values were significantly lower in the MCUD group compared to the control group. There was a significant positive correlation between neutrophil/lymphocyte ratio and platelet/lymphocyte ratio (r = .552 P < .001) and between systemic immune inflammatory index (SII) and systemic inflammation response index (SIRI) (r = 0.580 P < .001).

Conclusion: Methamphetamine and cannabis may affect the levels of inflammatory markers and SII and SIRI values through various mechanisms. To the best of our knowledge, this is the first study in the relevant literature, which investigated SII and SIRI values in patients with MCUD, therefore, the results can contribute to the future development of immune system-related markers in this field.