Psychiatry and Clinical Psychopharmacology最新文献

Restless back syndrome is characterized by uncomfortable pain, burning, ant crawling, or itching sensations in the back. Restless back syndrome is regarded as a back variant of restless legs syndrome. The lack of specific diagnostic criteria makes it difficult to recognize the restless back syndrome, which is usually neglected in clinical practice. Moreover, when a patient was diagnosed with restless back syndrome, the adjustment of medications was the first choice for doctors, which may make the patient's condition unstable. To describe the restless back syndrome and collect and review the related lecture, and the possible mechanism of restless back syndrome was analyzed. A 50-year-old man was diagnosed with schizophrenia 15 years ago. Starting with 25 mg/day aripiprazole, which was switched to amisulpride 0.6 g/day due to no effectiveness, the patient reported symptoms of restless back syndrome in the 2 weeks since the treatment with 0.6 g/day of amisulpride. With the reduction of amisulpride adjustment, restless back syndrome spontaneously remitted. The central dopaminergic dysfunction may play an important role in the development of restless back syndrome. This case suggests that psychiatrists should pay attention to restless back syndrome when using antipsychotics. Moreover, when a patient manifests restless back syndrome, observation or decreasing medication may be one choice.

Background: The level of uric acid and serum lipids has been suggested as a possible biomarker of bipolar disorder. We aimed to investigate the differences in clinical features and serum levels of lipids and uric acid in patients with bipolar depression or unipolar depression in order to distinguish them.

Methods: The clinical data of 53 patients with unipolar depression (unipolar group) and 61 patients with bipolar depression (bipolar group), who all met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders-IV of the American Psychiatric Association, were compared with each other retrospectively. The serum levels of uric acid and lipids (including total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides) were measured after hospital admission. The Statistical Package for the Social Science version 22.0 software was used for statistical analysis, and logistic regression was employed to identify the susceptible factors of bipolar depression.

Results: Taking into account confounding factors, logistic regression analysis revealed that the high levels of uric acid (odds ratio = 1.016, P = .001) and low levels of triglycerides (odds ratio = 0.457, P = .025) were significantly correlated with bipolar depression.

Conclusion: It has been demonstrated from this study that individuals with bipolar depression have higher serum uric acid levels and lower triglyceride levels than unipolar depression ones. Therefore, serum levels of uric acid and triglycerides might have the potential to be the biomarkers for differential diagnosis between bipolar and unipolar depression.

Background: Despite the frequent co-occurrence of posttraumatic stress disorder and substance use disorder, screening for trauma exposure and posttraumatic stress disorder symptoms is not a routine practice in substance use disorder clinics. The aims of this study were to examine the prevalence of exposure to traumatic events, posttraumatic stress disorder symptoms, and subjective sleep quality in substance use disorder inpatients after detoxification. In addition, we analyzed associations of sociodemographics, direct and indirect exposure to traumatic events, and sleep quality with posttraumatic stress disorder symptom severity.

Methods: Adults diagnosed with substance use disorder (n = 188; 25% women, mean age 46.6 ± 12.3 years) from 2 inpatient addiction clinics were assessed at approximately 4 days post-admission for age, gender, educational level, self-reported substance use, trauma exposure, general and posttraumatic stress disorder-specific subjective sleep quality, and posttraumatic stress disorder symptom severity. Correlates of posttraumatic stress disorder symptom severity were identified with linear regression analyses.

Results: The prevalence of direct trauma exposure was high (89%), 51% of participants screened positive for posttraumatic stress disorder and 87% reported clinically significant poor sleep quality. Younger age, female gender, direct and indirect exposure to more traumatic events, and poor subjective sleep quality were associated with more severe posttraumatic stress disorder symptoms.

Conclusion: Nearly all substance use disorder patients admitted for detoxification in our study had been directly or indirectly exposed to 1 or more traumatic events, and many reported posttraumatic stress disorder symptoms and poor sleep quality. Younger and female substance use disorder patients were at higher risk of posttraumatic stress disorder symptoms. Our results emphasize the need for systematic screening for direct and indirect trauma exposure, posttraumatic stress disorder symptoms, and poor sleep quality in patients admitted for clinical substance use disorder treatment.

Background: There is a correlation between the increase in reactive oxygen radicals and the presence of specific mental illnesses. In this context, the objective of this study is to investigate the relationship between obsessive-compulsive disorder and the variations in the levels of several endogenous oxidative stress markers.

Methods: Thirty obsessive-compulsive disorder patients were included in the study as the patient group, and 30 healthy volunteers of matching demographic characteristics were included in the study as the control group. Accordingly, the patient group consisted of 10 females and 20 males with a mean age of 29.5 ± 6.1 years, and the control group consisted of 15 females and 15 males with a mean age of 31.9±5.6 years. The serum nicotinamide adenine dinucleotide phosphate oxidase-2, nicotinamide adenine dinucleotide phosphate oxidase-4, and malondialdehyde levels of the 2 groups were compared using the independent samples t-test. The relationships between the serum nicotinamide adenine dinucleotide phosphate oxidase-2, nicotinamide adenine dinucleotide phosphate oxidase-4, and malondialdehyde levels of the 2 groups were analyzed using the Pearson's correlation coefficient.

Results: The serum nicotinamide adenine dinucleotide phosphate oxidase-2, nicotinamide adenine dinucleotide phosphate oxidase-4, and malondialdehyde levels of the patient group were statistically significantly higher than those of the control group (P < .001). Statistically significant positive correlations were detected between the serum nicotinamide adenine dinucleotide phosphate oxidase-2 and nicotinamide adenine dinucleotide phosphate oxidase-4 levels (r = 0.692, P = .001) and between the serum nicotinamide adenine dinucleotide phosphate oxidase-2 and malondialdehyde levels (r = 0.563, P = .001).

Conclusion: The results of this study indicated that oxidative stress and lipid peroxidation levels were higher in obsessive-compulsive disorder patients. Based on this finding, NOX-2 and NOX-4 levels can be used as indicators of endogenous oxidative stress in obsessive-compulsive disorder patients.

Background: It has been shown that autoimmune diseases are associated with psychiatric disorders in epidemiological studies. The acute psychiatric disorder patients have higher frequency of autoantibodies in the blood, including antinuclear antibodies, anti-thyroid peroxidase, and thyroglobulin [thyroid antibody carriers]. However, large clinical studies with more relevant control groups in China are few.

Methods: This was a retrospective study. A total of 1669 sera were tested for autoantibodies in the clinical laboratory of the Fourth Affiliated Hospital, Zhejiang University School of Medicine from October 2016 to March 2021. All data available during this time period were analyzed. Only the first entry for each patient from inpatient care units was used for analysis. The clinical information and laboratory data of patients were retrospectively collected and analyzed.

Results: A significantly lower prevalence of antinuclear antibodies was observed in the healthy control group than in the patient group (21.7% vs 28.8%, P < .05). There was a significant difference in the prevalence of antinuclear antibodies between thyroglobulin-antibody carriers and thyroid peroxidase-antibody- and thyroglobulin-antibody-seronegative individuals in the unipolar depressive disorder group (P < .05). A positive anti-thyroid peroxidase test was significantly associated with patients having nonaffective psychoses (P < .05).

Conclusion: The results showed that psychiatric disorders were associated with antinuclear antibodies and thyroid autoantibodies in our large sample of patients admitted to acute psychiatric hospitalization, and autoimmune autoantibodies were potential biomarkers of psychotic disorders. The results might lead to new research directions for the study of psychiatric disorders in the future.

Background: Reduced memory specificity (i.e., overgeneral memory) is a characteristic of autobiographical memories widely studied in clinical populations, and it is explained by rumination, functional avoidance, and executive dysfunction. Though the relationship of autobiographical memory specificity with mood and anxiety disorders has been shown, how it relates to dissociation is not well-established. Thus, we aimed to investigate whether dissociative experiences are related to overgeneral memory while considering concurrent depression as a possible confounding factor.

Methods: We conducted a systematic review in compliance with The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and searched PubMed and Web of Science databases using autobiograph* and dissoc* as our keywords.

Results: Of the 768 studies identified, 9 studies fulfilled the inclusion criteria. A meta-regression analysis was conducted to analyze the relationship between dissociative experiences and depression scores with autobiographical memory test scores. Our research revealed that depression scores, but not dissociative experiences, are significantly related to reduced memory specificity.

Conclusion: While the possible overlap between dissociation and depression should be considered in the interpretation of the findings, dissociative experiences do not seem to pose vulnerability for reduced specificity of autobiographical memory. The number of studies on the topic is limited, and they do not have longitudinal follow-ups. The heterogeneous reporting of memory scores and low scores of dissociative experiences in the samples are also limitations of the existing studies.

Background: This non-systematic narrative review aims to summarize the results of clinical studies evaluating the effectiveness of antidepressants used to treat mental illnesses including major depressive disorder, obsessive-compulsive disorder, somatization disorder, and anxiety disorders in Turkey. Conclusions drawn from this article can guide ongoing efforts by Turkish health policymakers to improve public health development in the country by further regulating the prescription of antidepressants.

Methods: Relevant articles regarding the effectiveness of antidepressant use were collected in June 2021 using Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus and Academic Search Complete online databases. The collected articles were then appraised using the Critical Appraisal Skills Programme to determine the reliability and quality of each article and to assess the risk of bias in each article. The summary of key findings/evidence, Critical Appraisal Skills Programme appraisal summary results, funding, study designs applied, settings covered, period covered (years), and additional comments were extracted from each article for analysis. The inclusion criteria involved articles that recounted adverse effects and effectiveness of antidepressant use in Turkey to treat mental illnesses, including anxiety disorders, major depressive disorder, somatization disorder, and obsessive-compulsive disorder. The exclusion criteria consisted of articles that included participants who resided outside of the geographic region of Turkey, abstracts, the pharmacology of antidepressant use, antidepressant off-label use, and alternative treatments.

Results: A total of 15 articles out of the 104 derived from the databases were included in the study that fell into 1 of the following main themes, "adverse effects" and "mixed results," which accounted for 53% (8 articles) and 40% (6 articles), respectively. One outlying article was identified (7%).

Conclusions: Totally 8 out of 15 articles that recounted antidepressants prescribed for mental illnesses produced adverse effects without treatment success and 6 out of 15 articles recounted adverse effects with treatment success. One outlying article found a confound that precluded determining whether an adverse effect was caused by antidepressant use or confounded by pre-existing conditions. Given that 14 out of 15 articles recounted adverse effects associated with antidepressant use and 6 out of 15 articles recounted antidepressant treatment success, Turkish policymakers are encouraged to adopt a restrictive drug policy strategy. To sum up, antidepressant prescription and consumption should be conducted with caution to limit unnecessary risk of exposure to adverse effects associated with antidepressant use. Limitations in the research included using a non-systematic tool instead of conducting a systematic review, a li

Background: The aim of this study is to compare the serum levels of Klotho and fibroblast growth factor 23 in patients with schizophrenia, in whom etiopathogenesis inflammation plays an important role, with those of healthy control subjects and to investigate a possible correlation between these levels.

Methods: Forty male patients with schizophrenia and 40 healthy male control subjects who were followed up and/or treated at the High-Security Forensic Psychiatry Clinic participated in the study. Sociodemographic data form, the Positive and Negative Syndrome Scale, and the Clinical Global Impression Scale were collected from all subjects, and participants' fibroblast growth factor 23 and Klotho serum levels were measured by the enzyme-linked immunosorbent assay method.

Results: The serum levels of Klotho and fibroblast growth factor 23 were significantly higher in schizophrenia patients than in healthy controls (P  = .048 and P  = .010, respectively). A significant positive correlation was observed between serum levels of Klotho and fibroblast growth factor 23 in subjects (r = 0.816; P  < .001).

Conclusion: Our study is the first to show significantly higher combined serum levels of fibroblast growth factor 23 and Klotho in patients with schizophrenia. The Klotho/fibroblast growth factor 23 pathway may play a role in the pathogenesis of schizophrenia. The involvement of Klotho and fibroblast growth factor 23 in inflammatory processes has the potential to provide alternative approaches to elucidate the etiopathogenesis and treatment of schizophrenia.

Background: With the recent legalization of cannabis for medical purposes in many countries, there has been an increased number of individuals using such products. While there is considerable evidence indicating that cannabis may have therapeutic effects for a range of different conditions, concerns remain about the risk of developing cannabis use disorders for those at risk, or patients without appropriate clinical guidance. The aim of the present study was to determine the prevalence of problematic cannabis use in a cohort of cannabis users who consumed the drug for medical purposes and to identify potential risk factors.

Methods: One hundred individuals who self-identified as using cannabis to improve their mental health were recruited from a community dispensary. Extensive details were collected about subjects' patterns of cannabis use and reasons for use. All subjects completed a structured clinical interview with the Mini-International Neuropsychiatric Interview, while information about perceived stress, depressive symptoms, and somatic symptoms were recorded with the Perceived Stress Scale-10, Beck Depression Inventory, and the Patient Health Questionnaire-15.

Results: Rates of problematic cannabis use were high, with 30% meeting the criteria. Only 10% of subjects reported medical cannabis use was recommended by their doctor. Significant risk factors for problematic use included earlier age of cannabis initiation, as well as self-reported use of cannabis products for depression.

Conclusions: The prevalence of problematic cannabis use in the community dispensary was higher than expected. Specific risk factors for problematic cannabis use may represent important areas for future intervention to ensure safer consumption for medical purposes.

Background: The coronavirus disease 2019 pandemic has remarkably challenged preschool teacher candidates, triggering concerns for their psychological well-being and mental health. Valid and reliable instruments to assess elements of mental health are thus required. The self-rating Hospital Anxiety Depression Scale demonstrates promise as an instrument for the identification and quantification of the states of anxiety and depression in non-psychiatric patients. The Hospital Anxiety Depression Scale is widely applied in both clinical and research contexts. However, no psychometric evaluations have been performed for this instrument with non-clinical samples such as preschool teacher candidates in South Korea. This study purposed to establish the factor structure of the Hospital Anxiety Depression Scale and to validate its Korean version and was conducted online with a sample of preschool teacher candidates during the peak of the coronavirus disease 2019 lockdown.

Methods: Data were collected from 359 undergraduates currently enrolled in a 4-year early childhood education degree program at a private university in Korea. The sample was randomly split to perform exploratory factor analysis and then confirmatory factor analysis respectively to test competing models hypothesized to reflect the factor structure of the Hospital Anxiety Depression Scale.

Results: Supplemental revisions based on confirmatory factor analysis modification indices demonstrated that a correlated 2-factor model with 1 cross-loaded item offered the best fit to the data with adequate internal reliability estimates.

Conclusion: Overall, this study confirms the validity and factor structure of the Korean version of the Hospital Anxiety Depression Scale, which is deemed an acceptable instrument that can be used to measure the symptoms of depression and anxiety in Korean preschool teacher candidates.