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Mendelian randomization analysis of maternal coffee consumption during pregnancy on offspring neurodevelopmental difficulties in the Norwegian Mother, Father and Child Cohort Study (MoBa). 挪威母亲、父亲和儿童队列研究》(MoBa)中母亲在怀孕期间饮用咖啡对后代神经发育障碍的孟德尔随机分析。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-09 DOI: 10.1017/S0033291724002216
Shannon D'Urso, Robyn E Wootton, Helga Ask, Caroline Brito Nunes, Ole A Andreassen, Liang-Dar Hwang, Gunn-Helen Moen, David M Evans, Alexandra Havdahl

Background: Previous observational epidemiological studies have suggested that coffee consumption during pregnancy may affect fetal neurodevelopment. However, results are inconsistent and may represent correlational rather than causal relationships. The present study investigated whether maternal coffee consumption was observationally associated and causally related to offspring childhood neurodevelopmental difficulties (NDs) in the Norwegian Mother, Father and Child Cohort Study.

Methods: The observational relationships between maternal/paternal coffee consumption (before and during pregnancy) and offspring NDs were assessed using linear regression analyses (N = 58694 mother-child duos; N = 22 576 father-child duos). To investigate potential causal relationships, individual-level (N = 46 245 mother-child duos) and two-sample Mendelian randomization (MR) analyses were conducted using genetic variants previously associated with coffee consumption as instrumental variables.

Results: We observed positive associations between maternal coffee consumption and offspring difficulties with social-communication/behavioral flexibility, and inattention/hyperactive-impulsive behavior (multiple testing corrected p < 0.005). Paternal coffee consumption (negative control) was not observationally associated with the outcomes. After adjusting for potential confounders (smoking, alcohol, education and income), the maternal associations attenuated to the null. MR analyses suggested that increased maternal coffee consumption was causally associated with social-communication difficulties (individual-level: beta = 0.128, se = 0.043, p = 0.003; two-sample: beta = 0.348, se = 0.141, p = 0.010). However, individual-level MR analyses that modelled potential pleiotropic pathways found the effect diminished (beta = 0.088, se = 0.049, p = 0.071). Individual-level MR analyses yielded similar estimates (heterogeneity p = 0.619) for the causal effect of coffee consumption on social communication difficulties in maternal coffee consumers (beta = 0.153, se = 0.071, p = 0.032) and non-consumers (beta = 0.107, se = 0.134, p = 0.424).

Conclusions: Together, our results provide little evidence for a causal effect of maternal coffee consumption on offspring NDs.

背景:以往的流行病学观察研究表明,孕期饮用咖啡可能会影响胎儿的神经发育。然而,研究结果并不一致,可能是相关关系而非因果关系。本研究调查了挪威母亲、父亲和儿童队列研究(Norwegian Mother, Father and Child Cohort Study)中母亲饮用咖啡是否与后代儿童神经发育障碍(NDs)存在观察上的关联和因果关系:采用线性回归分析法评估了母亲/父亲咖啡饮用量(孕前和孕期)与后代NDs之间的观察关系(母子二人组:58694人;父子二人组:22576人)。为了研究潜在的因果关系,我们使用以前与咖啡消费相关的基因变异作为工具变量,进行了个体水平(N = 46 245对母子)和双样本孟德尔随机化(MR)分析:我们观察到,母亲饮用咖啡与后代的社会交往困难/行为灵活性以及注意力不集中/多动冲动行为之间存在正相关(多重检验校正后的 p < 0.005)。观察发现,父亲饮用咖啡(阴性对照)与结果无关。在对潜在的混杂因素(吸烟、饮酒、教育和收入)进行调整后,母亲的相关性减弱为零。磁共振分析表明,孕产妇饮用咖啡量的增加与社交沟通障碍有因果关系(个体水平:β=0.128,se=0.043,p=0.003;双样本:β=0.348,se=0.141,p=0.010)。然而,对潜在多效应途径建模的个体水平 MR 分析发现,这种效应有所减弱(β=0.088,se=0.049,p=0.071)。个体水平的MR分析得出了相似的估计值(异质性p=0.619),即饮用咖啡对产妇社会沟通困难的因果效应(β=0.153,se=0.071,p=0.032)与非饮用者(β=0.107,se=0.134,p=0.424):总之,我们的研究结果几乎没有证明母体饮用咖啡对后代玖玖彩票网正规吗有因果影响。
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引用次数: 0
Lagged effects of childhood depressive symptoms on adult epigenetic aging. 童年抑郁症状对成年表观遗传衰老的滞后效应。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-07 DOI: 10.1017/S0033291724001570
Laura K M Han, Moji Aghajani, Brenda W J H Penninx, William E Copeland, Karolina A Aberg, Edwin J C G van den Oord

Background: Cross-sectional studies have identified health risks associated with epigenetic aging. However, it is unclear whether these risks make epigenetic clocks 'tick faster' (i.e. accelerate biological aging). The current study examines concurrent and lagged within-person changes of a variety of health risks associated with epigenetic aging.

Methods: Individuals from the Great Smoky Mountains Study were followed from age 9 to 35 years. DNA methylation profiles were assessed from blood, at multiple timepoints (i.e. waves) for each individual. Health risks were psychiatric, lifestyle, and adversity factors. Concurrent (N = 539 individuals; 1029 assessments) and lagged (N = 380 individuals; 760 assessments) analyses were used to determine the link between health risks and epigenetic aging.

Results: Concurrent models showed that BMI (r = 0.15, PFDR < 0.01) was significantly correlated to epigenetic aging at the subject-level but not wave-level. Lagged models demonstrated that depressive symptoms (b = 1.67 months per symptom, PFDR = 0.02) in adolescence accelerated epigenetic aging in adulthood, also when models were fully adjusted for BMI, smoking, and cannabis and alcohol use.

Conclusions: Within-persons, changes in health risks were unaccompanied by concurrent changes in epigenetic aging, suggesting that it is unlikely for risks to immediately 'accelerate' epigenetic aging. However, time lagged analyses indicated that depressive symptoms in childhood/adolescence predicted epigenetic aging in adulthood. Together, findings suggest that age-related biological embedding of depressive symptoms is not instant but provides prognostic opportunities. Repeated measurements and longer follow-up times are needed to examine stable and dynamic contributions of childhood experiences to epigenetic aging across the lifespan.

背景:横断面研究发现了与表观遗传衰老相关的健康风险。然而,目前还不清楚这些风险是否会使表观遗传时钟 "滴答作响"(即加速生物衰老)。本研究探讨了与表观遗传老化相关的各种健康风险在人体内的并发和滞后变化:方法:对 "大烟山研究"(Great Smoky Mountains Study)中的个体进行从 9 岁到 35 岁的跟踪调查。对每个人在多个时间点(即波)的血液中的 DNA 甲基化图谱进行了评估。健康风险包括精神、生活方式和逆境因素。并发(N = 539 人;1029 次评估)和滞后(N = 380 人;760 次评估)分析用于确定健康风险与表观遗传老化之间的联系:并发模型显示,体重指数(r = 0.15,PFDR < 0.01)与表观遗传老化在主体层面有显著相关性,但与波浪层面无关。滞后模型显示,青春期的抑郁症状(b = 1.67 个月/每个症状,PFDR = 0.02)加速了成年期的表观遗传老化,当模型完全调整了体重指数、吸烟、大麻和酒精的使用时也是如此:在人体内,健康风险的变化并不伴随表观遗传衰老的同步变化,这表明风险不太可能立即 "加速 "表观遗传衰老。然而,时滞分析表明,童年/青春期的抑郁症状预示着成年期的表观遗传衰老。综上所述,研究结果表明,与年龄相关的抑郁症状的生物嵌入并非一蹴而就,而是提供了预后机会。要研究童年经历对整个生命周期表观遗传衰老的稳定和动态影响,还需要重复测量和更长的随访时间。
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引用次数: 0
Time trends in adolescent depressive symptoms from 2010 to 2019 in Norway: real increase or artifacts of measurements? 2010年至2019年挪威青少年抑郁症状的时间趋势:是真正的增长还是测量的假象?
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-07 DOI: 10.1017/S0033291724002447
Sondre Aasen Nilsen, Kjell Morten Stormark, Lasse Bang, Geir Scott Brunborg, Marit Larsen, Kyrre Breivik

Background: Whether the recent rise in adolescent self-reported depressive symptoms is influenced by changing reporting behavior is much debated. Most studies use observed sum scores to document trends but fail to assess whether their measures are invariant across time, a prerequisite for meaningful inferences about change. We examined whether measurement noninvariance, indicative of changing perceptions and reporting of symptoms, may influence the assessment of time trends in adolescent depressive symptoms.

Methods: Data stem from the nationwide repeated cross-sectional Ungdata-surveys (2010-2019) of 560 712 responses from adolescents aged 13 to 19 years. Depressive symptoms were measured with the Kandel and Davies' six-item Depressive Mood Inventory. Using structural equation modeling, we examined measurement invariance across time, gender and age, and estimated the consequences of noninvariance on cross-cohort time trends.

Results: Across most conditions, the instrument was found measurement invariant across time. The few noninvariant parameters detected had negligible impact on trend estimates. From 2014, latent mean depressive symptom scores increased among girls. For boys, a U shaped pattern was detected, whereby an initial decrease in symptoms was followed by an increase from 2016. Larger issues of noninvariance were found across age in girls and between genders.

Conclusions: From a measurement perspective, the notion that changed reporting of symptoms has been an important driver of secular trends in depressive symptoms was not supported. Thus, other causes of these trends should be considered. However, noninvariance across age (in girls) and gender highlights that depressive symptoms are not necessarily perceived equivalently from early to late adolescence and across gender.

背景:青少年自我报告的抑郁症状最近有所上升,这是否是受报告行为变化的影响,目前还存在很多争议。大多数研究使用观察到的总分来记录趋势,但未能评估其测量值是否具有跨时间的不变性,而这是对变化进行有意义推断的先决条件。我们研究了测量的不变量(表明对症状的看法和报告的变化)是否会影响对青少年抑郁症状时间趋势的评估:数据来源于全国范围内的重复横截面 Ungdata-调查(2010-2019 年),共收到 560 712 份来自 13 至 19 岁青少年的回复。抑郁症状采用 Kandel 和 Davies 的六项抑郁情绪量表进行测量。通过结构方程模型,我们检验了跨时间、性别和年龄的测量不变量,并估计了不变量对跨队列时间趋势的影响:结果:在大多数情况下,我们发现该工具具有跨时间测量不变性。检测到的少数非变量参数对趋势估计的影响可以忽略不计。从 2014 年开始,女生的潜在平均抑郁症状分数有所增加。对于男生,发现了一种 U 型模式,即从 2016 年开始,症状最初减少,随后增加。在不同年龄段的女孩和不同性别之间发现了较大的非方差问题:从测量的角度来看,症状报告的变化是抑郁症状世俗趋势的重要驱动因素这一观点并不成立。因此,应考虑造成这些趋势的其他原因。然而,不同年龄(女孩)和不同性别的非方差性突出表明,从青春期早期到晚期以及不同性别对抑郁症状的看法并不一定相同。
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引用次数: 0
Predictive models of post-traumatic stress disorder, complex post-traumatic stress disorder, depression, and anxiety in children and adolescents following a single-event trauma. 单一事件创伤后儿童和青少年创伤后应激障碍、复杂创伤后应激障碍、抑郁和焦虑的预测模型。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-07 DOI: 10.1017/S0033291724001648
Jessica Memarzia, Katie Lofthouse, Tim Dalgleish, Adrian Boyle, Anna McKinnon, Clare Dixon, Patrick Smith, Richard Meiser-Stedman

Background: This study examined the power of theory-derived models to account for the development of PTSD, Complex PTSD (CPTSD), depression, and anxiety in children and adolescents who had experienced a single-event trauma.

Methods: Children (n = 234, aged 8-17 years) recruited from local Emergency Departments were assessed at two and nine weeks post-trauma. Data obtained from self-report questionnaires completed by the child, telephone interviews with parents, and hospital data were used to develop four predictive models of risk factors for PTSD, CPTSD, depression, and Generalized Anxiety Disorder (GAD). ICD-11 proposed diagnostic criteria were used to generate measures for CPTSD and PTSD to assess for risk factors and identify the sample prevalence of these disorders.

Results: At nine weeks post-trauma, 64% did not meet criteria for any disorder, 23.5% met criteria for PTSD, and 5.2% met criteria for CPTSD. 23.9% and 10.7% had developed clinically significant symptoms of depression and GAD, respectively. A cognitive model was the most powerful predictive model, a psychosocial model was weak, and subjective markers of event severity were more powerful than objective measures.

Conclusions: Youth exposed to single-incident trauma may develop different forms of psychopathology, and PTSD and CPTSD are frequently experienced alongside other conditions. The cognitive model of PTSD shows utility in identifying predictors of PTSD, CPTSD, depression, and GAD, particularly the role of trauma-related negative appraisals. This supports the application of cognitive interventions which focus upon re-appraising trauma-related beliefs in youth.

背景:本研究探讨了理论衍生模型在解释经历过单一事件创伤的儿童和青少年创伤后应激障碍、复杂创伤后应激障碍(CPTSD)、抑郁和焦虑的发展方面的作用:从当地急诊科招募的儿童(n = 234,8-17 岁)分别在创伤后两周和九周接受了评估。通过儿童填写的自我报告问卷、与家长的电话访谈以及医院数据获得的数据,用于建立创伤后应激障碍、创伤后应激障碍、抑郁症和广泛性焦虑症(GAD)风险因素的四个预测模型。采用 ICD-11 提出的诊断标准来生成 CPTSD 和创伤后应激障碍的测量方法,以评估风险因素并确定这些障碍的样本患病率:结果:在创伤后九周,64%的人不符合任何障碍的标准,23.5%的人符合创伤后应激障碍的标准,5.2%的人符合 CPTSD 的标准。分别有 23.9% 和 10.7% 的人出现了有临床意义的抑郁症和严重情感障碍症状。认知模型是最有力的预测模型,社会心理模型则较弱,事件严重性的主观指标比客观指标更有力:结论:遭受单一事件创伤的青少年可能会出现不同形式的精神病理学,创伤后应激障碍和创伤后精神紧张症经常与其他症状同时出现。创伤后应激障碍的认知模型在确定创伤后应激障碍、创伤后应激障碍、抑郁症和焦虑症的预测因素,尤其是与创伤相关的负面评价的作用方面显示出实用性。这支持了认知干预的应用,其重点是重新评价青少年与创伤有关的信念。
{"title":"Predictive models of post-traumatic stress disorder, complex post-traumatic stress disorder, depression, and anxiety in children and adolescents following a single-event trauma.","authors":"Jessica Memarzia, Katie Lofthouse, Tim Dalgleish, Adrian Boyle, Anna McKinnon, Clare Dixon, Patrick Smith, Richard Meiser-Stedman","doi":"10.1017/S0033291724001648","DOIUrl":"10.1017/S0033291724001648","url":null,"abstract":"<p><strong>Background: </strong>This study examined the power of theory-derived models to account for the development of PTSD, Complex PTSD (CPTSD), depression, and anxiety in children and adolescents who had experienced a single-event trauma.</p><p><strong>Methods: </strong>Children (<i>n</i> = 234, aged 8-17 years) recruited from local Emergency Departments were assessed at two and nine weeks post-trauma. Data obtained from self-report questionnaires completed by the child, telephone interviews with parents, and hospital data were used to develop four predictive models of risk factors for PTSD, CPTSD, depression, and Generalized Anxiety Disorder (GAD). ICD-11 proposed diagnostic criteria were used to generate measures for CPTSD and PTSD to assess for risk factors and identify the sample prevalence of these disorders.</p><p><strong>Results: </strong>At nine weeks post-trauma, 64% did not meet criteria for any disorder, 23.5% met criteria for PTSD, and 5.2% met criteria for CPTSD. 23.9% and 10.7% had developed clinically significant symptoms of depression and GAD, respectively. A cognitive model was the most powerful predictive model, a psychosocial model was weak, and subjective markers of event severity were more powerful than objective measures.</p><p><strong>Conclusions: </strong>Youth exposed to single-incident trauma may develop different forms of psychopathology, and PTSD and CPTSD are frequently experienced alongside other conditions. The cognitive model of PTSD shows utility in identifying predictors of PTSD, CPTSD, depression, and GAD, particularly the role of trauma-related negative appraisals. This supports the application of cognitive interventions which focus upon re-appraising trauma-related beliefs in youth.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":5.9,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Socioeconomic inequity in the utilization of healthcare among people with eating disorders in Australia. 澳大利亚饮食失调症患者在利用医疗保健方面的社会经济不平等。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-04 DOI: 10.1017/S0033291724002290
Moin Ahmed, Sarah Maguire, Kelly M Dann, Francisco Scheneuer, Marcellinus Kim, Jane Miskovic-Wheatley, Danielle Maloney, Natasha Nassar, Michelle Cunich

Background: Little is known about socioeconomic equity in access to healthcare among people with eating disorders in Australia. This study aims to measure the extent of inequity in eating disorder-related healthcare utilization, analyze trends, and explore the sources of inequalities using New South Wales (NSW) administrative linked health data for 2005 to 2020.

Methods: Socioeconomic inequities were measured using concentration index approach, and decomposition analysis was conducted to explain the factors accounting for inequality. Healthcare utilization included: public inpatient admissions, private inpatient admissions, visits to public mental health outpatient clinics and emergency department visits, with three different measures (probability of visit, total and conditional number of visits) for each outcome.

Results: Private hospital admissions due to eating disorders were concentrated among individuals from higher socioeconomic status (SES) from 2005 to 2020. There was no significant inequity in the probability of public hospital admissions for the same period. Public outpatient visits were utilized more by people from lower SES from 2008 to 2020. Emergency department visits were equitable, but more utilized by those from lower SES in 2020.

Conclusions: Public hospital and emergency department services were equitably used by people with eating disorders in NSW, but individuals from high SES were more likely to be admitted to private hospitals for eating disorder care. Use of public hospital outpatient services was higher for those from lower SES. These findings can assist policymakers in understanding the equity of the healthcare system and developing programs to improve fairness in eating disorder-related healthcare in NSW.

背景:人们对澳大利亚饮食失调患者在获得医疗保健方面的社会经济公平性知之甚少。本研究旨在利用新南威尔士州(NSW)2005 年至 2020 年的行政关联健康数据,测量与饮食失调相关的医疗保健利用方面的不平等程度,分析其趋势,并探索不平等的根源:方法:采用集中指数法测量社会经济不平等程度,并进行分解分析以解释造成不平等的因素。医疗保健使用情况包括:公立医院住院人数、私立医院住院人数、公立精神卫生门诊就诊人数和急诊就诊人数,每种结果都有三种不同的测量方法(就诊概率、总就诊人数和条件就诊人数):结果:2005 年至 2020 年期间,因饮食失调而入院治疗的患者主要集中在社会经济地位(SES)较高的人群中。同期,公立医院的入院概率没有明显的不平等。从 2008 年到 2020 年,社会经济地位较低的人更多地使用公共门诊。急诊室就诊率是公平的,但在 2020 年,社会经济地位较低的人使用急诊室就诊率更高:结论:新南威尔士州的饮食失调患者可以公平地使用公立医院和急诊科服务,但社会经济地位高的人更有可能到私立医院接受饮食失调治疗。社会经济地位较低的人使用公立医院门诊服务的比例更高。这些发现有助于政策制定者了解医疗保健系统的公平性,并制定相关计划以改善新南威尔士州与饮食失调相关的医疗保健的公平性。
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引用次数: 0
Digital assessment of nonverbal behaviors forecasts first onset of depression. 对非语言行为进行数字化评估,预测抑郁症的首次发病。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-04 DOI: 10.1017/S0033291724002010
Sekine Ozturk, Scott Feltman, Daniel N Klein, Roman Kotov, Aprajita Mohanty

Background: Adolescence is marked by a sharp increase in the incidence of depression, especially in females. Identification of risk for depressive disorders (DD) in this key developmental stage can help prevention efforts, mitigating the clinical and public burden of DD. While frequently used in diagnosis, nonverbal behaviors are relatively understudied as risk markers for DD. Digital technology, such as facial recognition, may provide objective, fast, efficient, and cost-effective means of measuring nonverbal behavior.

Method: Here, we analyzed video-recorded clinical interviews of 359 never-depressed adolescents females via commercially available facial emotion recognition software.

Results: We found that average head and facial movements forecast future first onset of depression (AUC = 0.70) beyond the effects of other established self-report and physiological markers of DD risk.

Conclusions: Overall, these findings suggest that digital assessment of nonverbal behaviors may provide a promising risk marker for DD, which could aid in early identification and intervention efforts.

背景介绍青春期的抑郁症发病率急剧上升,尤其是女性。在这一关键发育阶段识别抑郁障碍(DD)的风险有助于预防工作,减轻 DD 给临床和公众带来的负担。虽然非语言行为经常被用于诊断,但作为抑郁障碍的风险标志,其研究相对不足。数字技术(如面部识别)可以提供客观、快速、高效和经济的非语言行为测量手段:在此,我们通过市售的面部情绪识别软件分析了 359 名从未有过抑郁的青少年女性的临床访谈录像:结果:我们发现,头部和面部的平均动作可以预测未来抑郁症的首次发病(AUC = 0.70),超出了其他已确定的抑郁症风险自我报告和生理标记的影响:总之,这些研究结果表明,对非言语行为的数字化评估可能是一种很有前景的 DD 风险标记,有助于早期识别和干预工作。
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引用次数: 0
Influence of perceived harm due to substance use on the relationships between positive psychotic experiences and suicidal experiences in people with non-affective psychosis. 药物使用对非情感性精神病患者积极精神病体验和自杀体验之间关系的影响。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-04 DOI: 10.1017/S0033291724001764
Patricia Gooding, Kamelia Harris, Paula Duxbury, Daniel Pratt, Charlotte Huggett, Richard Emsley, Yvonne Awenat, Gillian Haddock

Background: The ways in which perceived harm due to substance use affects relationships between psychotic and suicidal experiences are poorly understood. The goal of the current study was to redress this gap by investigating the moderating effects of harm due to substance use on pathways involving positive psychotic symptoms, the perceived cognitive-emotional sequelae of those symptoms, and suicidal ideation.

Method: The design was cross-sectional. Mediation and moderated mediation pathways were tested. The predictor was severity of positive psychotic symptoms. Cognitive interpretative and emotional characteristics of both auditory hallucinations and delusions were mediators. Suicidal ideation was the outcome variable. General symptoms associated with severe mental health problems were statistically controlled for.

Results: There was evidence of an indirect pathway between positive psychotic symptom severity and suicidal ideation via cognitive interpretation and emotional characteristics of both auditory hallucinations and delusions. Harm due to drug use, but not alcohol use, moderated the indirect pathway involving delusions such that it was most prominent when harm due to drug use was at medium-to-high levels. The components of suicidal ideation that were most strongly affected by this moderated indirect pathway were active intent, passive desire, and lack of deterrents.

Conclusions: From both scientific and therapy development perspectives, it is important to understand the complex interplay between, not only the presence of auditory hallucinations and delusions, but the ensuing cognitive and emotional consequences of those experiences which, when combined with harm associated with substance use, in particular drug use, can escalate suicidal thoughts and acts.

背景:人们对因使用药物而感知到的伤害如何影响精神病和自杀经历之间的关系知之甚少。本研究的目的是通过调查药物使用所致伤害对精神病性症状、这些症状的认知情感后遗症和自杀意念之间的影响途径的调节作用来弥补这一空白:方法:采用横断面设计。方法:采用横断面设计,对中介和调节中介途径进行了测试。预测因素是阳性精神病症状的严重程度。幻听和妄想的认知解释和情感特征是中介因素。自杀意念是结果变量。对与严重精神健康问题相关的一般症状进行了统计控制:结果:有证据表明,通过幻听和妄想的认知解释和情感特征,阳性精神病症状严重程度与自杀意念之间存在间接联系。吸毒造成的伤害(而非酗酒)调节了涉及妄想的间接途径,因此当吸毒造成的伤害处于中高程度时,这种间接途径最为突出。自杀意念中受这种调节间接途径影响最大的成分是主动意图、被动愿望和缺乏威慑力:从科学和治疗发展的角度来看,重要的是要了解幻听和妄想之间复杂的相互作用,不仅要了解幻听和妄想的存在,还要了解这些经历随之产生的认知和情感后果,当这些后果与药物使用(尤其是毒品使用)带来的伤害相结合时,会使自杀想法和行为升级。
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引用次数: 0
Understanding variability: the role of meta-analysis of variance. 了解变异性:方差分析的作用。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-04 DOI: 10.1017/S0033291724001971
Oliver D Howes, George E Chapman

Meta-analyses traditionally compare the difference in means between groups for one or more outcomes of interest. However, they do not compare the spread of data (variability), which could mean that important effects and/or subgroups are missed. To address this, methods to compare variability meta-analytically have recently been developed, making it timely to review them and consider their strengths, weaknesses, and implementation. Using published data from trials in major depression, we demonstrate how the spread of data can impact both overall effect size and the frequency of extreme observations within studies, with potentially important implications for conclusions of meta-analyses, such as the clinical significance of findings. We then describe two methods for assessing group differences in variability meta-analytically: the variance ratio (VR) and coefficient of variation ratio (CVR). We consider the reporting and interpretation of these measures and how they differ from the assessment of heterogeneity between studies. We propose general benchmarks as a guideline for interpreting VR and CVR effects as small, medium, or large. Finally, we discuss some important limitations and practical considerations of VR and CVR and consider the value of integrating variability measures into meta-analyses.

传统的 Meta 分析是比较一个或多个相关结果的组间均值差异。然而,它们并不比较数据的分布(变异性),这可能意味着会遗漏重要的效应和/或亚组。为了解决这个问题,最近开发出了对变异性进行元分析比较的方法,因此现在是对这些方法进行回顾并考虑其优缺点和实施情况的时候了。利用已发表的重度抑郁症试验数据,我们展示了数据的分散如何影响总体效应大小和研究中极端观察结果的出现频率,从而对元分析的结论(如研究结果的临床意义)产生潜在的重要影响。然后,我们介绍了两种通过荟萃分析评估变异性组间差异的方法:方差比(VR)和变异系数比(CVR)。我们考虑了这些指标的报告和解释,以及它们与研究间异质性评估的不同之处。我们提出了一般基准,作为将 VR 和 CVR 效应解释为小、中或大的指南。最后,我们讨论了 VR 和 CVR 的一些重要局限性和实际注意事项,并考虑了将变异性测量纳入荟萃分析的价值。
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引用次数: 0
The case for eliminating excessive worry as a requirement for generalized anxiety disorder: a cross-national investigation. 消除过度担忧作为广泛性焦虑症的必要条件:一项跨国调查。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-04 DOI: 10.1017/S003329172400182X
Ayelet Meron Ruscio, Madeleine Rassaby, Murray B Stein, Dan J Stein, Sergio Aguilar-Gaxiola, Ali Al-Hamzawi, Jordi Alonso, Lukoye Atwoli, Guilherme Borges, Evelyn J Bromet, Ronny Bruffaerts, Brendan Bunting, Graça Cardoso, Stephanie Chardoul, Giovanni de Girolamo, Peter de Jonge, Oye Gureje, Josep Maria Haro, Elie G Karam, Aimee Karam, Andrzej Kiejna, Viviane Kovess-Masfety, Sue Lee, Fernando Navarro-Mateu, Daisuke Nishi, Marina Piazza, José Posada-Villa, Nancy A Sampson, Kate M Scott, Tim Slade, Juan Carlos Stagnaro, Yolanda Torres, Maria Carmen Viana, Cristian Vladescu, Zahari Zarkov, Ronald C Kessler

Background: Around the world, people living in objectively difficult circumstances who experience symptoms of generalized anxiety disorder (GAD) do not qualify for a diagnosis because their worry is not 'excessive' relative to the context. We carried out the first large-scale, cross-national study to explore the implications of removing this excessiveness requirement.

Methods: Data come from the World Health Organization World Mental Health Survey Initiative. A total of 133 614 adults from 12 surveys in Low- or Middle-Income Countries (LMICs) and 16 surveys in High-Income Countries (HICs) were assessed with the Composite International Diagnostic Interview. Non-excessive worriers meeting all other DSM-5 criteria for GAD were compared to respondents meeting all criteria for GAD, and to respondents without GAD, on clinically-relevant correlates.

Results: Removing the excessiveness requirement increases the global lifetime prevalence of GAD from 2.6% to 4.0%, with larger increases in LMICs than HICs. Non-excessive and excessive GAD cases worry about many of the same things, although non-excessive cases worry more about health/welfare of loved ones, and less about personal or non-specific concerns, than excessive cases. Non-excessive cases closely resemble excessive cases in socio-demographic characteristics, family history of GAD, and risk of temporally secondary comorbidity and suicidality. Although non-excessive cases are less severe on average, they report impairment comparable to excessive cases and often seek treatment for GAD symptoms.

Conclusions: Individuals with non-excessive worry who meet all other DSM-5 criteria for GAD are clinically significant cases. Eliminating the excessiveness requirement would lead to a more defensible GAD diagnosis.

背景:在世界各地,生活在客观困难环境中的人如果出现广泛性焦虑症(GAD)的症状,并不符合诊断条件,因为相对于环境而言,他们的担心并不过分。我们开展了首次大规模的跨国研究,探讨取消过度性要求的影响:数据来自世界卫生组织的世界心理健康调查倡议。我们采用国际综合诊断访谈法对中低收入国家(LMICs)的 12 项调查和高收入国家(HICs)的 16 项调查中的 133 614 名成年人进行了评估。将符合 DSM-5 所有其他 GAD 标准的非过度焦虑者与符合所有 GAD 标准的受访者以及无 GAD 的受访者在临床相关性方面进行了比较:去除过度性要求后,全球 GAD 终生患病率从 2.6% 上升到 4.0%,低收入国家的增幅大于高收入国家。非过度性和过度性 GAD 患者对许多事情的担忧是相同的,但与过度性 GAD 患者相比,非过度性 GAD 患者对亲人健康/福利的担忧更多,而对个人或非特定问题的担忧较少。非过度型病例在社会人口特征、GAD 家族史、时间上的继发性合并症和自杀风险方面与过度型病例非常相似。虽然非过度型病例的平均严重程度较低,但他们报告的损伤程度与过度型病例不相上下,并且经常寻求治疗 GAD 症状:结论:患有非过度焦虑症但符合 DSM-5 中所有其他 GAD 标准的患者是具有临床意义的病例。取消过度性要求将使 GAD 诊断更有辩护理由。
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引用次数: 0
Genetic and molecular correlates of cortical thickness alterations in adults with obsessive-compulsive disorder: a transcription-neuroimaging association analysis. 强迫症成人皮层厚度改变的遗传和分子相关性:转录-神经影像关联分析。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-10-04 DOI: 10.1017/S0033291724001909
Da Zhang, Changjun Teng, Yinhao Xu, Lei Tian, Ping Cao, Xiao Wang, Zonghong Li, Chengbin Guan, Xiao Hu

Background: Although numerous neuroimaging studies have depicted neural alterations in individuals with obsessive-compulsive disorder (OCD), a psychiatric disorder characterized by intrusive cognitions and repetitive behaviors, the molecular mechanisms connecting brain structural changes and gene expression remain poorly understood.

Methods: This study combined the Allen Human Brain Atlas dataset with neuroimaging data from the Meta-Analysis (ENIGMA) consortium and independent cohorts. Later, partial least squares regression and enrichment analysis were performed to probe the correlation between transcription and cortical thickness variation among adults with OCD.

Results: The cortical map of case-control differences in cortical thickness was spatially correlated with cortical expression of a weighted combination of genes enriched for neurobiologically relevant ontology terms preferentially expressed across different cell types and cortical layers. These genes were specifically expressed in brain tissue, spanning all cortical developmental stages. Protein-protein interaction analysis revealed that these genes coded a network of proteins encompassing various highly interactive hubs.

Conclusions: The study findings bridge the gap between neural structure and transcriptome data in OCD, fostering an integrative understanding of the potential biological mechanisms.

背景:强迫症是一种以侵入性认知和重复性行为为特征的精神障碍,尽管大量神经影像学研究已经描述了强迫症患者的神经改变,但人们对大脑结构变化和基因表达之间的分子机制仍然知之甚少:本研究将艾伦人类大脑图谱数据集与来自元分析(ENIGMA)联盟和独立队列的神经影像数据相结合。随后,研究人员进行了偏最小二乘法回归和富集分析,以探究强迫症成人患者转录与皮层厚度变化之间的相关性:结果:皮质厚度病例对照差异的皮质图谱与在不同细胞类型和皮质层优先表达的神经生物学相关本体术语的加权组合基因的皮质表达存在空间相关性。这些基因在脑组织中特异性表达,跨越了大脑皮层的所有发育阶段。蛋白质-蛋白质相互作用分析表明,这些基因编码的蛋白质网络包含各种高度交互的枢纽:研究结果弥合了强迫症神经结构与转录组数据之间的差距,促进了对潜在生物学机制的综合理解。
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引用次数: 0
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Psychological Medicine
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