Psychiatry and Clinical Psychopharmacology最新文献

Background: Patients with unilateral breast loss after single mastectomy for breast cancer may have body image disorders such as surgical lymphedema, flap ischemia, and spinal deformity, resulting in negative emotions such as depression, inferiority, and social dysfunction. This study mainly investigated and analyzed the status quo and influencing factors of body image disorder in breast cancer patients after single mastectomy.

Methods: This study is a cross-sectional study. Breast cancer patients admitted from May 2023 to April 2024 were selected as the research subjects. Data were collected with a general information questionnaire, the Body Image Scale (BIS), the Self-Image Scale, the Self-Acceptance Questionnaire, and the Perceived Social Support Scale. Based on the scores, the research subjects were divided into a body image disturbance group and a non-disturbance group. Univariate and multiple logistic regression analyses were conducted to analyze the influencing factors of body image disturbances in breast cancer patients.

Results: One hundred fifty questionnaires were distributed in this study, and 146 valid questionnaires were collected. Among the 146 patients, 51 (34.93%) experienced body image disturbances after surgery, while 95 (65.07%) did not. The results of univariate and multiple logistic regression analyses showed that educational level, lymphedema in the affected limb, intimate relationships, self-image, self-acceptance, and perceived social support scores were independent risk factors for body image disturbances in breast cancer patients after surgery (P < .05).

Conclusion: Body image disturbances in breast cancer patients who undergo unilateral mastectomy need further improvement. Educational level, lymphedema in the affected limb, intimate relationships, self-image, self-acceptance, and perceived social support are the main influencing factors.

Background: The aim of this quantitative study conducted with 5008 individuals aged 15 and above in 12 provinces across Turkey was to determine the prevalence and significant variables of gambling behavior in our country and to examine the gambling behaviors, perceptions, thoughts, and attitudes of this population towards gambling. The goal is to generate concrete, original, culturally sensitive, feasible, and effective recommendations for preventive and risk-reducing policies. It is the first and only comprehensive investigation into gambling behavior in Turkey, offering guidance in this field.

Methods: In this study, which was conducted with an epidemiological cross-sectional design, a stratified random sampling technique was employed, and data were collected using computer-assisted faceto-face interviews. Individuals to be surveyed in households were randomly selected using the Kish method.

Results: Three hundred forty-one participants (6.81%) reported having gambled at least once (GALO) in their lifetime, while the remaining participants stated they had never gambled (NG). Among the GALO group, 100 individuals (29.33%) reported regular participation in gambling activities during the data collection period. The most commonly played types of gambling were sports betting (55.4%), national lottery (42.2%), numeric lottery (34.6%), and bingo (30.8%). The ages of first-time gambling ranged from 6 to 41. Tobacco, alcohol, and substance use were significantly more common in the GALO group compared to the NG group (P < .001).

Conclusion: Understanding the prevalence of gambling behavior and underlying motivations is crucial for creating awareness and implementing effective preventive measures. We must determine its prevalence, examine societal attitudes, highlight its presence, and prioritize solution-oriented strategies.

Background: This study aimed to investigate miRNAs and upstream regulatory transcription factors involved in schizophrenia (SZ) pathogenesis.

Methods: Differential expression of miRNAs and genes in SZ patients was investigated utilizing the gene expression omnibus dataset, gene ontology annotations, and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analysis. Real-time quantitative polymerase chain reaction experiments were conducted to validate the predictive screening of regulatory genes in peripheral blood samples from 20 SZ patients and 20 healthy controls. The diagnostic potential of these factors within these samples was assessed via receiver operating characteristic (ROC) curve analyses.

Results: Fifty-eight miRNAs were identified as differentially expressed in the peripheral blood of SZ patients. miR-26b-5p exhibited significantly reduced expression in SZ patients compared to healthy individuals. Additionally, 1422 mRNAs were differentially expressed, including 5 transcription factors potentially regulating miR-26b-5p expression. Among these, EGR1 and STAT1 displayed significantly lower expression levels in SZ patients. Receiver operating characteristic analysis revealed areas under the curve of 0.76 for miR-26b-5p, 0.74 for EGR1, 0.82 for STAT1, and 0.85 for the combined STAT1-miR-26b-5p diagnosis.

Conclusion: The reduced expression of miR-26b-5p, EGR1, and STAT1 in the peripheral blood of SZ patients, compared to healthy controls, suggests a strong association with SZ. These molecules represent potential diagnostic biomarkers, with the combined marker STAT1-miR-26b-5p potentially offering enhanced diagnostic accuracy.

Background: Weighted blankets have recently introduced in the treatment on insomnia as a nonpharmacological integrative therapy. Here we prospectively evaluated the effects of weighted blankets on the sleep structure and heart rate variability (HRV) in patients with primary psychophysiological insomnia.

Methods: In this prospective polysomnographic (PSG) study between August 2021 and August 2022, patients were given weighted blankets (~10% of body weight) to use at home for 10 nights consecutively. Clinical examination and scales including Turkish Version of Basic Scale on Insomnia Complaints, Quality of Sleep (BaSIQS), and Pittsburgh sleep quality index (PSQI) were performed before and after therapy.

Results: The mean age of a total of 26 patients was 48.7 ± 9.4 years, and 69.2% were males. Sixteen patients (69.2%) showed benefit from weighted blankets as measured by BaSIQS (P=.005) and PSQI (P=.003). In objective PSG measures, sleep latency was also decreased (P=.040) with increased percentage of N3 sleep (P=.034). On the other side, obstructive apnea-hypopnea index was significantly increased (P=.038). Heart rate variability parameters did not show significant changes.

Conclusion: Weighted blankets should be considered as a promising non-pharmacological option in practical therapies of chronic psychophysiological insomnia. An increase in obstructive apneas/ hypopneas necessities a screening for sleep apnea.

Background: This study was designed to determine the effects of acceptance and commitment care in the treatment of aplastic anemia (AA) patients with recombinant human thrombopoietin (rhTPO).

Methods: The clinical records of 100 AA patients treated at our hospital from March 2021 to March 2023 were analyzed in the retrospective study. All patients received immunosuppressants and rhTPO. Among them, 46 patients who received routine care from March 2021 to March 2022 were allocated to the control group, and the other 54 patients who received acceptance and commitment care from April 2022 to March 2023 were assigned to the study group. The quality of life (QoL) of the 2 groups was assessed by the MOS 36-Item Short-Form Health Survey (SF-36) before care and after 3 months of care. Blood-related indicators after care were compared in 2 groups.

Results: Before care, no significant inter-group discrepancy was observed in SF-36 scores in all dimensions (P > .05); whereas after nursing, the SF-36 scores of both groups increased conspicuously in all dimensions (P < .001), especially the study group (P < .001). After care, no significant differences were observed in hemoglobin (Hb), platelet count (PLT), and white blood cell count (WBC) between the 2 groups (P > .05). A conspicuously lower overall response rate was observed in the control group in contrast to the study group (P = .044), and no significant inter-group discrepancy was found in the total incidence of adverse reactions (P = .506).

Conclusion: Acceptance and commitment care is conducive to the patients with AA treated by rhTPO, because it substantially improves the QoL of patients, without increasing adverse reactions, so it is worth promoting.

Background: Interventional therapy, currently, has become a major method for the clinical treatment of liver cancer patients. However, interventional therapy can also lead to various toxic side effects, and combined with the impact of the disease itself, liver cancer patients often experience more severe emotional distress. Improving individuals' levels of psychological distress tolerance may reduce sensitivity to negative life events and experiences. At this stage, there is no relevant literature reporting on the psychological distress tolerance of liver cancer patients after interventional therapy. This study investigates and analyzes psychological distress tolerance in liver cancer patients after interventional therapy, aiming to optimize personalized nursing interventions and improve patients' long-term quality of life.

Methods: This study is a cross-sectional study. Convenience sampling is adopted. Liver cancer patients who underwent interventional therapy in our hospital from August 2023 to May 2024 were selected. General Information Questionnaire, Psychological Distress Tolerance Scale, Psychological Resilience Scale, Fear of Progression Questionnaire-Short Form, and Perceived Social Support Scale were used for data collection. Multiple linear regression analysis was performed to identify the influencing factors of psychological distress tolerance in liver cancer patients after interventional therapy.

Results: The total score of psychological distress tolerance in 157 liver cancer patients was 26.88 ± 4.15, with item scores for each dimension ranging from low to high, namely, pain endurance and pain management. The results of multiple linear regression analysis showed that age, tumor size, number of tumors, psychological resilience, fear of disease progression, and perceived social support were influencing factors of psychological distress tolerance in liver cancer patients after interventional therapy (P < .05).

Conclusion: The level of psychological distress tolerance in liver cancer patients after interventional therapy needs to be improved, and it is relevant to age, tumor size, number of tumors, psychological resilience, fear of disease progression, and perceived social support.

Background: The Kahramanmaras earthquakes occurred on February 6, 2023. Two powerful earthquakes, occurring 9 hours apart, resulted in over 50000 deaths and affected more than 14 million people. This study assessed different characteristics among affected children and adolescents and identified vulnerable groups. This study aimed to evaluate post-earthquake psychiatric symptoms among children and adolescents, determine the prevalence of acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) among affected children and adolescents, and identify personal and event-related factors that influence these outcomes.

Methods: Patients admitted to the child psychiatry outpatient clinic or consulted from the emergency and pediatric inpatient clinics were evaluated for the effect of personal and event-related factors, including demographic variables, pre-event mental state, loss of relatives and assets owned, and medical/surgical requirements, on their mental health.

Results: The study revealed that sleep problems were prevalent as the primary psychiatric symptom among children and adolescents following the earthquake. The incidence of ASD remained similar between age groups, while PTSD was more commonly observed in adolescents. Patients experiencing the loss of family members or friends, as well as those whose homes collapsed or suffered extensive damage, and those who sustained physical injuries, exhibited a higher prevalence of ASD and PTSD compared to the other patients.

Conclusion: Current findings reveal that the delivery of intensive psychological support in the early stages is crucial to prevent further mental problems in vulnerable groups following an earthquake.

Renal transplantation is the treatment of choice for patients with end-stage renal failure as it provides patients with the best quality of life because of its survival benefits, either short or long-term. However, despite the benefits of renal transplantation over dialysis, the life-long immunosuppressant treatment needed after kidney transplantation has several drawbacks. The present case developed a psychotic disorder after 8 years of regular intake of immunosuppressant medications tacrolimus and prednisone. He was switched to cyclosporine, and the dose of prednisone was decreased, but he only showed partial improvement in his behavior. The patient was started on the antipsychotic drug risperidone, and the delusions subsided within 12 weeks of starting the medication. This case highlights the importance of clinical awareness of rare but severe psychiatric effects due to immunosuppressant use. In conclusion, early recognition of psychiatric side effects of immunosuppressants and systemic corticosteroids and starting appropriate treatment is essential to prevent more serious psychiatric side effects.

Background: The objective is to compare the risk of developing type 2 diabetes (T2D) within a year in patients prescribed various antidepressants (ADs) and those prescribed fluoxetine as a control group.

Methods: This study used standardized data from the Health Insurance Review and Assessment Service claims database (n=1,456,489). Patients aged ≥10 years with no previous use of ADs and no history of diabetes mellitus, regardless of whether they were diagnosed with any depressive disorder, were eligible for this study. Among these eligible patients, those who had used ADs for the first time or had never used them between January 2017 and December 2017 were selected for this study. I compared the short-term (<12 months) risk of T2D in patients using various ADs, excluding tricyclic ADs, with those using fluoxetine as a control. The Cox proportional hazards model was used to calculate hazard ratios (HRs).

Results: The HRs (95% confidence intervals) for T2D incidence in the various AD groups compared with that in the fluoxetine group are as follows: 0.84 (0.67-1.06, P = .15), bupropion; 0.91 (0.77- 1.07, P=.25), tianeptine; 0.91 (0.77-1.07, P=.25), escitalopram; 0.96 (0.82-1.13, P = .63), paroxetine; 0.97 (0.70-1.35, P=.87), fluvoxamine; 1.07 (0.85-1.36, P=.55), vortioxetine; 1.07 (0.91-1.25, P=.42), sertraline; 1.14 (0.99-1.31, P = .07), duloxetine; 1.17 (0.97-1.41, P = .09), mirtazapine; 1.17 (1.00-1.38, P=.05), trazodone; 1.22 (1.04-1.45, P=.02), venlafaxine; and 1.29 (1.03-1.61, P = .03), milnacipran.

Conclusion: The short-term risk of T2D was significantly higher in the milnacipran and venlafaxine groups than in the fluoxetine group. All other ADs except milnacipran and venlafaxine showed no difference in the risk of developing T2D compared to fluoxetine. These results suggest that clinicians should be mindful of the risk of developing T2D when administering milnacipran and venlafaxine to patients.

Background: Assessment of medication adherence of patients with severe mental disorders is an important aspect of long-term treatment. There is a need for a brief and practical tool to assess medication adherence. This study investigates the clinical, functional, and validational correlations of a short and easy-to-use tool.

Methods: Global Assessment of Medication Adherence (GAMA) was prepared as a single item with 5 severity degrees, from complete adherence (1 point) to complete nonadherence (5 points). The scale was applied to patients with severe mental illnesses receiving outpatient and inpatient treatment. The GAMA scores were compared with psychopathology, clinical severity, insight, and functionality scale scores. While the validity analyses were tested with face, convergent, and criterion validity, interrater reliability was used for the reliability analysis.

Results: Data from 70 outpatients and 14 inpatients were examined. In the analyses performed for convergent validity, a positive correlation was found between GAMA scores and psychopathology (r=0.646, P < .001), and clinical severity (r = 0.692, P < .001), and a significant negative correlation was found between GAMA scores and insight (r = −0.793, P < .001), and functionality (r = −0.740, P < .001). There was a significant difference in the GAMA scores of 14 patients assessed during hospitalization and discharge. A high positive correlation was found between the GAMA measurements of the psychiatrist and the nurse at admission and discharge.

Conclusion: This study shows that the GAMA has sufficient psychometric properties for assessing medication adherence. Due to its brevity, simplicity, and validity, the scale is appropriate for use in routine clinical practice and research.