Psychiatry and Clinical Psychopharmacology最新文献

Background: Approximately 30% of autism spectrum disorder (ASD) cases exhibit developmental regression after a period of typical development, leading to what is known as regressive autism. Our understanding of the factors underlying regression, including precise mechanisms, clinical features, and risk factors, remains limited. This study aims to compare children with ASD with language regression (ASD-LR) to those without developmental regression (ASD-NR) in terms of clinical and demographic characteristics and to identify potential predictors.

Methods: In this cross-sectional retrospective study, children aged 2-6 diagnosed with ASD-LR were matched for age and gender with children diagnosed with ASD-NR between January 2023 and January 2024. The groups were compared in terms of demographic and clinical characteristics.

Results: The mean age of the ASD-LR group (n = 32) was 52.16 ± 14.56 months, and the ASD-NR group (n = 50) had a mean age of 48.76 ± 13.41 months. Univariate analyses revealed no significant differences in autism severity between groups in clinician (P = .367) and parent evaluations (P = .541). However, in the ASD-LR group, a significant relationship was found between regression, a history of febrile seizures (P = .012), a father's psychiatric background (P = .002), and a family history of psychiatric disorders (P < .001). Family history of psychiatric disorders (OR 7.54, 95% CI 1.10-51.64, P = .040) and cesarean delivery (odds ratio 3.90, 95% CI 1.05-14.47, P = .042) were identified as independent predictors of language regression.

Conclusion: The results indicate that regression may be associated with both genetic and environmental factors, including a family history of psychiatric disorders, cesarean delivery, and febrile seizure. Future research should focus on explaining these factors and identifying potential preventive measures.

Background: The aim of this study was to evaluate the peripheral expression of ADORA2A (Adenosine A2A receptor gene) in young subjects with autism spectrum disorder compared with healthy controls and its relationship with clinical characteristics.

Method: This study included 93 children and adolescents with a diagnosis of autism spectrum disorder as the study group and 105 healthy age- and gender-matched controls. Blood samples were obtained from all participants, and a real-time quantitative polymerase chain reaction was performed. Parent- and clinician-rated assessment instruments were used to assess and rate the severity of autism spectrum disorder and other emotional/behavioral problems.

Results: The mean age of the study group was 9.06 ± 3.57 and 86% were male (n = 83), whereas the mean age of the control group was 9.22 ± 3.86 and 86.7% were male (n = 91). We have found a higher level of peripheral expression of ADORA2A in children and adolescents with autism spectrum disorder compared with healthy controls (fold change = 1.33, P = .001). We also found a weak negative correlation with autism spectrum disorder severity (r = -0.216; P = .038) and stereotyped behaviors (r = -0.207, P = .046).

Conclusion: ADORA2A genes may have a role in the pathophysiology of autism spectrum disorder. Further studies are needed to evaluate whether peripheral expression of ADORA2A genes may be among the biomarkers for diagnosing or measuring the severity of autism spectrum disorder.

Priapism is a painful and prolonged erection of the penis without sexual stimulation. Priapism can be seen due to both typical and atypical antipsychotic drug use. A 51-year-old male who was followed up with a diagnosis of schizophrenia for 30 years and was switched from oral aripiprazole to paliperidone palmitate due to psychotic exacerbation was reported in this study. About 1 month after starting the drug, the patient presented to the emergency department with a painful and prolonged penile erection lasting 3-4 hours. Following the diagnosis of priapism by urology, the patient was relieved by intracavernous adrenaline injection and corpus cavernosum drainage and was referred to psychiatric consultation. Since the patient's examination, history, and laboratory tests could not detect a condition that could cause priapism, it was thought that priapism might be due to antipsychotic medication. One week after stopping paliperidone palmitate injection, the patient had another attack of priapism. Ten days after the second priapism, the patient was started on olanzapine, 10 mg/day, which was increased to 20 mg/day in the follow-up. The patient has been using olanzapine 20 mg/day for the past year. He is still psychiatrically stable and has no signs of priapism. To the best of our knowledge, this is the second case of recurrent priapism associated with paliperidone palmitate use.

Background: Stigma discrimination against people who meet the criteria for mental disorders is frequent in Colombian adolescents; however, there is no valid and reliable instrument for measurement. The study aimed to establish the Reported and Intended Behavior Scale psychometric performance among Colombian adolescents.

Methods: A validation study was carried out with 350 students aged between 10 and 17, 53.7% of whom were girls. The authors estimated frequencies for reported behaviors and measured internal consistency and confirmatory factor analysis for intended behaviors. The Reported and Intended Behavior Scale has 2 sub-scales-reported and intended behaviors, with 4 items each.

Results: The reported behavior sub-scale ranged from 10.0% to 24.9%, whereas the intended behavior sub-scale presented a Cronbach's alpha of 0.88 (95% CI: 0.86-0.90) and a McDonald omega of 0.88. For the confirmatory factor analysis, Kaiser-Meyer-Olkin was 0.81, Bartlett chi-squared, was 771.1 (df = 6, P = .001), and Eigen value was 2.95 that explained 73.9% of the total variance. For the goodness-of-fit tests, chi-squared was 21.9 (df = 2, P = .001), root mean square error of approximation was 0.17 (90% CI: 0.11-0.24), Comparative Fit Index was 0.97, Tucker-Lewis Index was 0.92, and standardized root mean square residual was 0.03.

Conclusions: The Reported and Intended Behavior Scale can measure reported behaviors, and the intended behavior sub-scale shows high internal consistency. However, the dimensionality of the intended behavior sub-scale presents modest goodness-of-fit indexes. These findings need replications.

Background: EMPATHY IN HEALTHCARE is an intensive 20-hour experiential training program based on mediation techniques and specialized healthcare role-play for clinicians and medical students. It is hypothesized that the training will improve empathy via the intensive experiential techniques implemented.

Methods: A total of 50 medical students (25 males/25 females) took the course voluntarily. Empathy was measured using the Jefferson Scale of Empathy-Medical Students Version (JSE-S) (Greek version), before and after the 20-hour training, along with a 6-month follow-up. Gender, age, preferred medical specialty and baseline empathy score were explored as possible moderator variables of the training effect.

Results: Empathy increased after training, with a mean JSE-S score improvement of 11.25 points (±8.848) (P < .001). After 6 months, the mean JSE-S score maintained a difference of 6.514 points (±12.912) (P < .005). No differences were recorded with regard to gender, age group or medical specialty for the pooled data. Women in the 22-24 year-old age group had a 5-point mean difference (P = .05), and higher post-training scores than men. Lower initial scorers were the ones that mostly improved, with a 3-fold mean score difference from the higher scorers regardless of gender (P < .001), while also showing a smaller drop in empathy levels 6 months after the training compared to the higher scorers.

Conclusion: Intensive experiential training can improve empathy in a clinical setting. EMPATHY IN HEALTHCARE is a successful training program in improving empathy in medical students, as measured by the JSE-S. A score of 110 and below could be used for selecting medical student candidates who will benefit most from empathy training.

Objective: Bipolarity index (BI) is one of the diagnostic scales that assist the diagnosis of bipolar disorder (BD), and should be analyzed comprehensively for use in China.

Methods: We searched the Chinese Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), WANFANG, and Chinese Social Sciences Citation Index (CSSCI) in Chinese to find literature from July 31, 2004 to July 31, 2020, for results related to BI in the diagnosis for bipolar disorder (BD), among which results such as comments, letters, reviews, and case reports were excluded. The rates of sensitivity, specificity, accuracy, positive predictive value, and negative predictive value in diagnosis were synthesized and discussed.A total of 1237 patients were included in 5 studies. The criteria used for their selection were an anlysis of their results on the BI, and the diagnostic indexes of BI for BD in China.Thesensitivity, specificity, positive predictive value, negative predictive value, and accuracy of BI for BD in China were summarized in every study.Results: A total of 1237 subjects were included in 5 studies. The random effect model was used to account for the data with RevMan 5.2. The results showed that the diagnostic sensitivity of BI was 0.93 (95% CI: 0.93-1.00), and the specificity was 85% (95% CI: 0.69-0.96). The positive predictive value (PPV)was 74% (95% CI: 0.53-0.91). The negative predictive value (NPV) was 95% (95% CI: 0.81-1.00), and accuracy was 86% (95% CI: 0.77-0.93). Significant heterogeneity was detected across studies regarding these incidence estimates.Conclusion: The ideal diagnostic value of BI was found, although the studies showed significant heterogeneity. The results must be cautiously and attentively interpreted, in comparison to other diagnostic scales, to perfect the use of BI in clinical psychiatry.

Background: Schizophrenia is a serious mental illness affecting 0.3-0.7% of the world's population. It is a classic quantitative genetic disease and is affected by a variety of common and rare genetic variants.

Methods: To facilitate personalized and precise medicine for schizophrenia treatment, we designed a program by genotyping a panel of related genes for schizophrenic patients using MassARRAY time-of-flight mass spectrometry. The program was tested in an observational clinical study conducted at the Hulunbuir Mental Health Center of China. In the study, a total of 254 patients diagnosed with schizophrenia were recruited and genotyped. The genotyping results were used to generate reports listing where the 16 included antipsychotics should be placed: "Use as directed," "Use with caution," or "Use with caution and with frequent blood concentration monitoring" categories. Seventy-two of the patients completed the 24-week follow-up observation, during which their PANSS scores were assessed at eight time points.

Results: For all of the subjects who completed the study, the PANSS scores dropped significantly, showing the effectiveness of the treatment. During the 24-week study, PANSS scores of patients whose medications were consistent (N = 48) with their genetic test results dropped from 84.3 (SD = 12.4) to 58.8 (SD = 15.3), and average PANSS change rate reached 56.1% after 24 weeks. In contrast, PANSS scores of patients with genetic tests reported as "Use with caution" or "Use with caution and with frequent blood concentration monitoring" (N = 24) dropped from 81.1 (SD = 10.5) to 63.8 (SD = 10.1), and their average PANSS change rate was 37.6%.

Conclusions: This research indicates that our pharmacogenomic-based program could be a suitable and effective tool to facilitate precise medication in schizophrenia treatment.

Background: While global attention has focused largely on the effects of the coronavirus on physical health, the effects of the coronavirus on mental health cannot be ignored. Therefore, this study aims to investigate the effects of COVID-19 disease on mental health and its relationship with other clinical variables.

Methods: In this study, adult patients over 18 years of age who were diagnosed with COVID 19 by real time-polymerized chain reaction (RT-PCR) method in our city were included. By using some psychological scales, psychological influence was determined in the study subjects.

Results: DASS-21 anxiety and total scores were higher in female patients than males. COVID-19 Fear Scale, DASS-21 anxiety, depression, and total scores were higher in married patients than single ones. Patients living in rural areas had higher Fear of COVID-19 scale, DASS-21, depression, and total scores and lower Life Satisfaction Scale scores compared to those living in city centers. Patients with any chronic illness and psychiatric disorder had higher COVID-19 Fear Scale, DASS-21 anxiety, and total scores. The presence of respiratory symptoms and positive CT pneumonia were closely associated with higher scale scores.

Conclusions: We suggest that the COVID-19 outbreak seems to also affect patients psychologically. This influence is more in COVID-19 positive patients who were females, married, those living in rural areas, ones with chronic medical or psychiatric disorder, and ones with respiratory symptoms and positive CT findings. Future studies with face-to-face interviews are required to prove this observation further.