Psychiatry and Clinical Psychopharmacology最新文献

With the rapid acceleration of global aging, the prevalence of Alzheimer's disease (AD) continues to rise, exerting a profound impact on elderly individuals' physical health, lifestyle, and quality of life. Exercise has demonstrated significant research value and broad application potential in AD as a non-pharmacological preventive and therapeutic approach. This study aims to provide a bibliometric and visual analysis of research related to exercise and AD over the past decade. It seeks to identify research hotspots and development trends, explore the layers of research on exercise's impact on AD, and clarify its preventive effects and molecular mechanisms. The Web of Science Core Collection database was used as the data source for this study. A comprehensive search was conducted using the topic "exercise for Alzheimer's disease," covering the period from January 1, 2014, to August 31, 2024. CiteSpace and Python were employed to perform bibliometric and visual analyses on these publications, including assessments of publication trends, keyword co-occurrence, clustering analysis, timeline analysis, burst detection analysis, and the distribution and growth trends of molecular mechanisms related to exercise and AD. 1. Annual publication trends: 6134 articles were included in the analysis. The number of publications on exercise and AD increased steadily from 2014 to 2024 (β = 53.23,P < .001). 2. Keyword co-occurrence and clustering analysis: research on exercise and AD primarily focuses on themes related to cognitive decline, risk factors, exercise-induced energy metabolism, exercise intensity, and molecular mechanisms. 3. Keyword timeline and burst analysis: epidemiological and clinical studies maintained high activity levels in the early and mid-stages of the research timeline, whereas molecular-level studies exhibited increased activity in the later stages. 4. Molecular mechanisms distribution: analysis of molecular mechanisms reveals that amyloid-beta deposition and oxidative stress remain the predominant research areas. Meanwhile, research on neuroinflammation, brain-derived neurotrophic factor (BDNF), Tau pathology, and other related mechanisms has been further explored. The findings demonstrate a progressive shift in research focus from general epidemiological patterns to more in-depth investigations of molecular biological mechanisms. Exercise has been shown to play a preventive role at the clinical level by improving cognitive function and mitigating risk factors and at the molecular level by modulating key pathological mechanisms, including β-amyloid deposition, oxidative stress, BDNF, tau pathology, and others. Through the coordinated regulation of multiple targets and pathways, exercise exerts a neuroprotective effect against AD.

Background: The objective of this research is to present the demographic and clinical features of children diagnosed with autism spectrum disorder (ASD) in the past, who have achieved an optimal level of improvement. One of the recurrent inquiries of the parents of children with an ASD diagnosis pertains to the prognosis of their offspring and the potential for improvement. This study aims to investigate children who lose the ASD diagnosis (LAD). Methods: This study retrospectively reviewed the medical records of 1465 children and adolescents aged 0-18 who were diagnosed with ASD between December 2017 and June 2021, and followed up by a child and adolescent psychiatrist. The files of a total of 50 LAD patients were analyzed. In addition to sociodemographic information, the patient's educational background, prenatal and postnatal complications, developmental milestones, other medical conditions, medications used, symptoms at the time of ASD diagnosis, and developmental/mental assessment results were also examined. Results: A sample of 50 cases was obtained and analyzed. The majority of the sample consisted of males, with a median age of 2.45 (min 1.17-max 7) years at the time of receiving the ASD diagnosis, and 5.5 (min 2.25-max 11.3) years at the time of losing the diagnosis. There was a positive and moderately significant relationship between the age of receiving the diagnosis and the age of losing the diagnosis (r=0.634, P < .001). Ninety-two percent of the sample received a mean of 2.29 ± 1.77 years of special education. Additionally, 26% of the sample still had an additional psychiatric diagnosis, with attention deficit hyperactivity disorder and speech sound disorder being the most common. Eighteen percent of the sample was found to be taking medication, primarily risperidone. Conclusion: This study shows that a subset of monitored children may lose their diagnosis, but further research to determine the clinical characteristics, symptomatology, and biological factors of this group of children will be more informative regarding optimal outcome processes.

Background: Pregnancy can be challenging for women in various manners and can boost the risk of intentional self-poisonings. The aim of the study is to evaluate the occurrence and clinical characteristics of poisonings and the relationship between suicidal tendency and increased systemic inflammatory load during pregnancy.

Methods: This study was performed in a tertiary hospital emergency department using 10 years of data. The study covered 69 female individuals, 35 pregnant and 34 non-pregnant, with acute poisoning diagnoses. The cases' sociodemographic and clinical features, as well as routine blood results, were evaluated. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) markers were calculated to assess systemic inflammatory load.

Results: The intentional suicide rate in pregnant women was 85.71% (n = 30). Pregnant individuals had significantly higher PLR (P < .001) and NLR (P = .001) levels compared to the control group. The NLR values in intentional poisonings and the PLR in accidental poisonings were found to be proportionally higher, but the difference between both groups was not statistically significant (P = .448 and P = .701, respectively).

Conclusion: The vast majority of acute poisonings in pregnant women were intentional. Although the inflammatory burden values were significantly higher in pregnant women than in controls, there was not enough strong evidence to establish a link between increased inflammatory burden and suicidal tendencies in pregnant women.

Background: The goal of this study was to retrospectively appraise the efficacy of the combined therapy comprising mannitol and nimodipine for hypertensive intracerebral hemorrhage (HICH) and its impact on neurological function.

Methods: The study subjects encompassed 100 individuals with HICH who were admitted to the hospital from May 2021 to 2023 and were categorized into a control group and an observation group, with 50 individuals comprising each group. Intravenous mannitol infusion was administered to the control group, while the observation group received nimodipine injection in combination with mannitol, followed by a course of oral nimodipine tablets. Both groups of patients were treated for 3 months. A comparative analysis was performed to assess the clinical efficacy, neurological function, hematoma volume, serum inflammatory cytokine levels, hemodynamic parameters, and incidence of adverse reactions across the 2 groups.

Results: A remarkably higher overall response rate of 92.00% was observed in the treatment group as opposed to 74.00% in the control group, with both groups exhibiting noteworthy reductions in National Institutes of Health Stroke Scale scores post-treatment, and the reduction being more pronounced in the treatment group (P < .05). Post-treatment, both groups exhibited decreases in hematoma volume and edema area, with the reduction in the observation group being notably more significant than in the control group (P < .05). Post-treatment, there was an upsurge in cerebral blood flow and blood flow velocity, coupled with a reduction in peripheral resistance and critical pressure in both groups. The observation group displayed higher blood flow velocity and lower peripheral resistance and critical pressure than the control group (P < .05). No notable distinction was observed in the overall incidence of adverse reactions between the groups (P > .05).

Conclusion: The concurrent administration of mannitol and nimodipine in HICH presents substantial advantages, including enhanced clinical efficacy, improved neurological function, decreased hematoma volume, and regulation of hemodynamic parameters. This treatment approach has shown significant efficacy and is worthy of widespread promotion and application in clinical practice.

Background: Parkinson's disease (PD) is a prevalent neurodegenerative disorder characterized by a multifaceted genetic foundation. We hypothesized that combining whole-genome sequencing (WGS) with whole-exome sequencing (WES) in a multi-generational family affected by PD could identify rare and novel variants of genes associated with PD.

Methods: This study included a family showing multiple members affected by PD and exhibiting an apparent dominant inheritance pattern. Seventeen family members were genotyped by WES and 6 of them was additionally analyzed by WGS. The common variants were validated by Sanger sequencing.

Results: Forty-seven genes that may be associated with PD were identified by co-separation analysis, clustering analysis, correlation analysis of resequencing data, and 2 of them were common. For these two genes, polymerase chain reaction (PCR) and Sanger sequencing were performed in family members, and quantitative PCR (qPCR) was conducted in 6 sporadic PD patients and 6 controls to detect mRNA expression. It was found that the Ddx56 mutation frequency (chr7: 44610462) was significantly different between PD and control in the family. Additionally, the DEAD-box helicase 56(Ddx56) gene was down-regulated in PD patients, outside the family members, while Ccdc42 mutation frequency and mRNAexpression had no significant difference.

Conclusion: Therefore, it was speculated that the mutation of Ddx56 in exon (chr7: 44610462) might be related to the occurrence of PD.

Background: The present study aimed to find the electroencephalography (EEG) characteristics of adult attention-deficit/hyperactivity disorder (ADHD) and to examine if these EEG indices are associated with insomnia in adult ADHD.

Methods: Twenty-six participants were included in the adult ADHD group, and 26 sex-, age-, and education-matched participants formed the control group. Between-group differences in the resting-state EEG indices and the score of insomnia scale were assessed. Correlational analysis between these EEG indices and the score of insomnia scale was conducted.

Results: The adult ADHD group had more insomnia problems and showed increased power over 4 frequency bands at electrodes frontal area, Cz, and Pz, except for alpha band at electrode frontal area. Furthermore, some EEG indices, especially over fast frequency bands, are associated with the score of insomnia scale.

Conclusion: The findings of this study reveal that adult ADHD shows a distinct EEG pattern during the resting state. The correlation between the EEG indices over fast frequency bands in adult ADHD and the score of the insomnia scale may explain the high prevalence of insomnia in adult ADHD.

Background: Major depressive disorder (MDD) is a serious mental disorder that is common worldwide and is associated with somatic symptoms. Cognitive and behavioral problems caused by depression can negatively affect problem-solving skills, and somatic symptoms related to depression can intensify this effect. Although the relationship between depression and problem-solving skills has been investigated in the literature, the mediating role of somatic symptoms in this relationship has not been sufficiently examined. This study aims to investigate the effect of somatic symptoms on problem-solving skills in patients with depression. Methods: This study included 200 patients diagnosed with MDD according to Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria who applied to the psychiatry outpatient clinic of Recep Tayyip Erdogan University Training and Research Hospital between March 2021 and March 2022. The sociodemographic data form, Structured Clinical Interview for DSM-5 Disorders Clinician Version, Hamilton Depression Rating Scale, Beck Depression Inventory, Problem Solving Inventory, and Somatosensory Amplification Scale were administered to the participants. The obtained data were analyzed using the SPSS v26.0 program. Results: Around 111 (55.5%) of the participants had somatic symptoms, and depression levels were found to be higher in this group. Somatic symptoms were more common in women and older individuals. Participants with somatic symptoms exhibited more hasty and avoidant approaches to problem-solving skills and used thoughtful, evaluative, planned, and self-confident approaches less. In addition, it was observed that problem-solving skills improved with increasing education levels. It was determined that somatic symptoms had a mediating role in the effect of depression on problem-solving skills. Conclusion: This study is the first in the literature to evaluate the relationship between somatic symptoms and problem-solving skills in patients with depression. This study shows that somatic symptoms have a negative effect on problem-solving skills in depressed individuals. The presence of somatic symptoms leads to the use of less effective strategies in the problem-solving process, which can exacerbate the cognitive symptoms of depression. Approaches aimed at reducing somatic symptoms in treatment processes can strengthen the problem-solving skills of depressed individuals and improve treatment outcomes.

Background: This research is focused on evaluating the influence of administering cinepazide maleate and edaravone together on cerebral blood flow and neurofunctional markers in individuals who have recently suffered from an acute ischemic stroke (AIS).

Methods: Included in this retrospective investigation were 100 patients diagnosed with AIS and treated at our medical center between the period of December 2022 and December 2023. These individuals were subsequently segregated into 2 cohorts according to the different treatments they received, consisting of 50 patients each, referred to as the control group and the observation group. Upon admission, standard treatment was initiated for all patients, alongside additional edaravone therapy for the control group, and concurrent administration of cinepazide maleate and edaravone for the observation group, for a consecutive period of 14 days. The study involved the assessment of cerebral blood flow in the middle cerebral artery (MCA) and anterior cerebral artery (ACA), in addition to the evaluation of neurofunctional markers, serum inflammatory factors, activities of daily living (ADL) scores, and National Institutes of Health Stroke Scale (NIHSS) scores. Adverse reactions were closely monitored to determine the treatment's efficacy.

Results: Subsequent to the treatment, augmented blood flow velocities were observed in both the MCA and ACA for both groups, particularly evident in the observation group. The observation group also demonstrated raised levels of nerve growth factor and lower levels of neuron-specific enolase and S100-β, with more notable differences when contrasted with the control group. Additionally, the observation group displayed reduced levels of tumor necrosis factor-alpha and monocyte chemoattractant protein-1, and elevated levels of interleukin-10 (IL-10), with more substantial variations as opposed to the control group. Furthermore, the observation group indicated enhanced ADL scores and diminished NIHSS scores, with more notable differences compared to the control group. The overall treatment effectiveness reached 94.00% in the observation group, markedly surpassing the 74.00% achieved in the control group.

Conclusion: The concurrent application of cinepazide maleate and edaravone yields notable effects on cerebral blood flow and contributes to the improvement of neurofunctional capabilities in individuals dealing with AIS.

Background: Childhood traumas (CTs) affect the etiology of generalized anxiety disorder (GAD) and the interpersonal relationship dimensions (IRDs) in these individuals. Traumatic experiences are related to anger control problems and interpersonal relationships (IRs) in these individuals. In this study, individuals diagnosed with GAD and healthy controls (HC) were compared in terms of CTs, IRDs, and anger ruminations (ARs), and the mediating role of ARs in the relationship between CTs and IRDs in individuals with GAD was tried to be determined.

Methods: Patients who applied to the Psychiatry Outpatient Clinic of Sultan II. Abdulhamid Han Education and Research Hospital and were diagnosed with GAD according to DSM-V diagnostic criteria (n = 378) and the HC group (n = 195) was evaluated in terms of demographic variables, CTs, IRDs, and ARs.

Findings: CTs, IRDs, and ARs levels were higher in those diagnosed with GAD than in the HC group. There was a significant relationship between the mean age and ARs levels (P =-.184, P < .001) and between CTs and IRDs levels (r = 0.241, P < .001) in the patient group. ARs were found to have a mediating role in the relationship between CTs and IRDs.

Conclusion: Our results suggest that CTs are associated with ARs in individuals diagnosed with GAD and therefore increase the tendency to have problems with IRs. Evaluating ARs at the beginning of the treatment process in GAD individuals is important both in terms of contributing to the treatment process of the disease and determining the risk factors or supradiagnostic factors that maintain the disease.

Background: Attention deficit/Hyperactivity d isorder (ADHD) affects the quality of life not only of children but also of their caregivers, particularly parents. This study investigates the effects of ADHD treatment on the burden, anxiety, and depression experienced by the parents of children with ADHD.

Methods: This study involved 92 children diagnosed with ADHD, aged 6-17 years and their primary caregivers. Both children and caregivers participated in a structured psychiatric interview based on the DSM-V criteria. At the start of treatment and again 3 months later, the children's behavioral problems were assessed using the Conners' Parent Rating Scale-Revised: Short Form (CPRS-R:S). Caregiver outcomes were evaluated using the Burden Assessment Scale (BAS), the Hamilton Anxiety Rating Scale (HARS), and the Hamilton Depression Rating Scale (HDRS).

Results: A statistically significant reduction in caregiver burden was observed in the BAS scores from the time of ADHD treatment initiation to 3 months later (P < .001, r ^a = 0.56). The highest BAS scores were consistently associated with hyperactivity, while the lowest scores were noted in caregivers of children with attention-deficit-dominant ADHD, both before and 3 months after treatment (P < .001, η² = 0.312; P < .001, η² = 0.314, respectively). The caregivers' HARS and HDRS scores decreased after 3 months of treatment, although this change was not statistically significant (P = .47 and P = .36, respectively).

Conclusion: Attention deficit/hyperactivity disorder treatment significantly reduced the caregiver burden within 3 months, highlighting the importance of timely diagnosis and treatment of ADHD for improving children's symptoms and relieving the caregiver burden of their parents.