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Examining the association between aggression and suicide attempts among army soldiers. 研究军队士兵的攻击行为与自杀企图之间的关联。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-25 DOI: 10.1017/S0033291724002460
Alison Krauss, Ashley L Greene, Emily R Edwards, Marianne Goodman

Background: Suicide is a major concern among active-duty military personnel. Aggression represents a salient risk factor for suicide among civilians, yet is relatively understudied among military populations. Although several theories posit a relation between aggression and suicide with putative underlying mechanisms of social isolation, access to firearms, and alcohol use, researchers have yet to test these potential mediators. This study uses rich, longitudinal data from the Army Study to Assess Risk and Resilience (STARRS) Pre/Post Deployment Study (PPDS) to examine whether aggression longitudinally predicts suicide attempts and to identify mediators of this association.

Methods: Army soldiers (N = 8483) completed assessments 1 month prior to deployment and 1, 2-3, and 9-12 months post-deployment. Participants reported on their physical and verbal aggression, suicide attempts, social network size, firearm ownership, and frequency of alcohol use.

Results: As expected, pre-deployment aggression was significantly associated with suicide attempts at 12-months post-deployment even after controlling for lifetime suicide attempts. Social network size and alcohol use frequency mediated this association, but firearm ownership did not.

Conclusions: Findings further implicate aggression as an important suicide risk factor among military personnel and suggest that social isolation and alcohol use may partially account for this association.

背景:自杀是现役军人关注的一个主要问题。攻击行为是平民自杀的一个突出风险因素,但对军人自杀的研究却相对不足。虽然有几种理论认为攻击行为与自杀之间存在关系,其潜在机制包括社会隔离、获得枪支和饮酒,但研究人员尚未对这些潜在的中介因素进行测试。本研究利用军队风险和复原力评估研究(STARRS)部署前/后研究(PPDS)中丰富的纵向数据,研究攻击行为是否能纵向预测自杀企图,并确定这种关联的中介因素:陆军士兵(N = 8483)在部署前 1 个月、部署后 1 个月、2-3 个月和 9-12 个月完成了评估。参与者报告了他们的身体和言语攻击行为、自杀企图、社交网络规模、枪支拥有量以及饮酒频率:结果:正如所料,即使在控制了终生自杀未遂的情况下,部署前的攻击行为与部署后 12 个月的自杀未遂仍有显著关联。社会网络规模和酗酒频率对这种关联起到了中介作用,但枪支拥有量则没有:研究结果进一步表明,攻击行为是军人自杀的一个重要风险因素,并表明社会隔离和饮酒可能是造成这种关联的部分原因。
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引用次数: 0
A comparative meta-analysis of structural magnetic resonance imaging studies and gene expression profiles revealing the similarities and differences between late life depression and mild cognitive impairment. 结构磁共振成像研究和基因表达谱的比较荟萃分析揭示了晚年抑郁症和轻度认知障碍之间的异同。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-25 DOI: 10.1017/S0033291724002563
Ling Zhao, Lijing Niu, Haowei Dai, Tatia M C Lee, Ruiwang Huang, Ruibin Zhang

Background: Late-life depression (LLD) predisposes individuals to cognitive decline, often leading to misdiagnoses as mild cognitive impairment (MCI). Voxel-based morphometry (VBM) can distinguish the profiles of these disorders according to gray matter (GM) volumes. We integrated findings from previous VBM studies for comparative analysis and extended the research into molecular profiles to facilitate inspection and intervention.

Methods: We comprehensively searched PubMed and Web of Science for VBM studies that compared LLD and MCI cases with matched healthy controls (HCs) from inception to 31st December 2023. We included 13 studies on LLD (414 LLDs, 350 HCs) and 50 on MCI (1878 MCIs, 2046 HCs). Seed-based d Mapping with Permutation of Subject Images (SDM-PSI) was used for voxel-based meta-analysis to assess GM atrophy, spatially correlated with neuropsychological profiles. We then used multimodal and linear-model analysis to assess the similarities and differences in GM volumetric changing patterns. Partial least squares (PLS) regression and gene enrichment were employed for transcription-neuroimaging associations.

Results: GM volumes in the left hippocampus and right parahippocampal gyrus are more affected in MCI, along with memory impairment. MCI was spatially correlated with a more extensive reduction in the levels of neurotransmitters and a severe downregulation of genes related to cellular potassium ion transport and metal ion transmembrane transporter activity.

Conclusion: Compared to LLD, MCI exhibited more GM atrophy in the hippocampus and parahippocampal gyrus and lower gene expression of ion transmembrane transport. Our findings provided imaging-transcriptomic-genetic integrative profiles for differential diagnosis and precise intervention between LLD and MCI.

背景:晚年抑郁症(LLD)易导致个人认知能力下降,经常被误诊为轻度认知障碍(MCI)。基于体素的形态计量学(VBM)可以根据灰质(GM)体积区分这些疾病的特征。我们整合了以前的 VBM 研究结果进行比较分析,并将研究扩展到分子特征,以方便检查和干预:我们在 PubMed 和 Web of Science 上全面检索了从开始到 2023 年 12 月 31 日期间比较 LLD 和 MCI 病例与匹配健康对照(HCs)的 VBM 研究。我们纳入了 13 项关于 LLD(414 例 LLD,350 例 HC)和 50 项关于 MCI(1878 例 MCI,2046 例 HC)的研究。我们使用基于种子的受试者图像迭代映射(SDM-PSI)进行基于体素的荟萃分析,以评估与神经心理学特征空间相关的基因组萎缩。然后,我们使用多模态和线性模型分析来评估 GM 体积变化模式的异同。我们还采用了偏最小二乘法(PLS)回归和基因富集法来分析转录与神经影像之间的关联:结果表明:MCI患者左侧海马和右侧海马旁回的基因组体积受到更大影响,同时记忆力也受到损害。MCI在空间上与神经递质水平更广泛的降低以及细胞钾离子转运和金属离子跨膜转运活性相关基因的严重下调相关:结论:与 LLD 相比,MCI 在海马和海马旁回表现出更多的 GM 萎缩,离子跨膜转运的基因表达更低。我们的研究结果为LLD和MCI的鉴别诊断和精确干预提供了成像-转录组-基因综合图谱。
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引用次数: 0
Review and consensus on pharmacogenomic testing in psychiatry. 精神病学药物基因组学检测回顾与共识。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-25 DOI: 10.1017/S0033291724002095
Mark Faiz, Sanjida Ahmed
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引用次数: 0
Cannabis use and cognitive biases in people with first-episode psychosis and their siblings. 大麻使用与首发精神病患者及其兄弟姐妹的认知偏差。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-22 DOI: 10.1017/S0033291724001715
L Roldan, T Sánchez-Gutiérrez, I Fernández-Arias, E Rodríguez-Toscano, G López, J Merchán-Naranjo, A Calvo, M Rapado-Castro, M Parellada, C Moreno, L Ferraro, D La Barbera, C La Cascia, G Tripoli, M Di Forti, R M Murray, D Quattrone, C Morgan, C Gayer-Anderson, P B Jones, H E Jongsma, J B Kirkbride, J van Os, P García-Portilla, S Al-Halabí, J Bobes, L de Haan, M Bernardo, J L Santos, J Sanjuán, M Arrojo, A Szoke, B P Rutten, S A Stilo, I Tarricone, A Lasalvia, S Tosato, P-M Llorca, P Rossi Menezes, J-P Selten, A Tortelli, E Velthorst, C M Del-Ben, C Arango, C M Díaz-Caneja

Background: Cannabis use and familial vulnerability to psychosis have been associated with social cognition deficits. This study examined the potential relationship between cannabis use and cognitive biases underlying social cognition and functioning in patients with first episode psychosis (FEP), their siblings, and controls.

Methods: We analyzed a sample of 543 participants with FEP, 203 siblings, and 1168 controls from the EU-GEI study using a correlational design. We used logistic regression analyses to examine the influence of clinical group, lifetime cannabis use frequency, and potency of cannabis use on cognitive biases, accounting for demographic and cognitive variables.

Results: FEP patients showed increased odds of facial recognition processing (FRP) deficits (OR = 1.642, CI 1.123-2.402) relative to controls but not of speech illusions (SI) or jumping to conclusions (JTC) bias, with no statistically significant differences relative to siblings. Daily and occasional lifetime cannabis use were associated with decreased odds of SI (OR = 0.605, CI 0.368-0.997 and OR = 0.646, CI 0.457-0.913 respectively) and JTC bias (OR = 0.625, CI 0.422-0.925 and OR = 0.602, CI 0.460-0.787 respectively) compared with lifetime abstinence, but not with FRP deficits, in the whole sample. Within the cannabis user group, low-potency cannabis use was associated with increased odds of SI (OR = 1.829, CI 1.297-2.578, FRP deficits (OR = 1.393, CI 1.031-1.882, and JTC (OR = 1.661, CI 1.271-2.171) relative to high-potency cannabis use, with comparable effects in the three clinical groups.

Conclusions: Our findings suggest increased odds of cognitive biases in FEP patients who have never used cannabis and in low-potency users. Future studies should elucidate this association and its potential implications.

背景:吸食大麻和家族性精神病易感性与社会认知缺陷有关。本研究探讨了大麻使用与初发精神病(FEP)患者及其兄弟姐妹和对照组的社会认知和功能基础认知偏差之间的潜在关系:我们采用相关性设计分析了来自 EU-GEI 研究的 543 名 FEP 患者、203 名兄弟姐妹和 1168 名对照组样本。在考虑人口统计学和认知变量的情况下,我们使用逻辑回归分析来研究临床组别、终生大麻使用频率和大麻使用效力对认知偏差的影响:与对照组相比,FEP 患者出现面部识别处理(FRP)缺陷的几率增加(OR = 1.642,CI 1.123-2.402),但出现言语错觉(SI)或妄下结论(JTC)偏差的几率却没有增加,与兄弟姐妹相比没有统计学意义上的显著差异。在整个样本中,与终生禁欲相比,每日和终生偶尔吸食大麻与出现 SI(OR = 0.605,CI 分别为 0.368-0.997 和 OR = 0.646,CI 分别为 0.457-0.913 )和 JTC 偏差(OR = 0.625,CI 分别为 0.422-0.925 和 OR = 0.602,CI 分别为 0.460-0.787 )的几率降低有关,但与 FRP 缺陷无关。在大麻使用者群体中,相对于使用高浓度大麻,使用低浓度大麻增加了 SI(OR = 1.829,CI 1.297-2.578)、FRP 缺陷(OR = 1.393,CI 1.031-1.882)和 JTC(OR = 1.661,CI 1.271-2.171)的几率,在三个临床群体中效果相当:我们的研究结果表明,从未使用过大麻的 FEP 患者和低效大麻使用者出现认知偏差的几率增加。未来的研究应阐明这种关联及其潜在影响。
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引用次数: 0
Which behavioral regulations predict physical activity and sedentary behavior in people with mental illness? 哪些行为规范可以预测精神病患者的体育锻炼和久坐行为?
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-21 DOI: 10.1017/S0033291724001879
Justin Chapman, Nicole Korman, Eva Malacova, Caroline Robertson, Urska Arnautovska, Dan Siskind, Shuichi Suetani, Brendon Stubbs, Davy Vancampfort

Background: Moderate-to-vigorous physical activity (MVPA) is beneficial for health, and reducing sedentary behavior (SB) is recommended in international guidelines. People with mental illnesses are at higher risk of preventable diseases than the general population, partly attributable to lower MVPA and higher SB. Self-determination theory provides a framework for understanding how motivation regulates behavior. This study aimed to evaluate the contribution of different forms of motivation for physical activity (amotivation, controlled, autonomous) to MVPA and SB in people with mental illnesses.

Methods: Cross-sectional self-reported and accelerometer-derived MVPA and SB in people with a range of mental illnesses across four countries were pooled for analysis (Australia, Belgium, England, Uganda). Motivation for physical activity was measured using the Behavioural Regulation in Exercise Questionnaire (BREQ). Regression analyses were used to investigate the association of MVPA and SB with amotivation, controlled, autonomous motivations, controlling for mental health and demographic variables.

Results: Autonomous motivation was associated with 31% higher self-reported MVPA, and amotivation and controlled motivation were associated with 18% and 11% lower self-reported MVPA, respectively (n = 654). In contrast, controlled motivation was positively associated with SB (n = 189). Having physical comorbidities or an alcohol use disorder was associated with lower MVPA (n = 318). Sub-analyses with accelerometer-derived MVPA and SB (n = 139 and n = 145) did not reveal any associations with motivational forms.

Conclusions: Findings with an international sample support the universal relevance of motivation in promoting health-related behavior. Strategies for facilitating autonomous motivation should be utilized by health professionals seeking to support people with mental illnesses to become physically active.

背景:适度到剧烈运动(MVPA)有益健康,国际指南建议减少久坐行为(SB)。与普通人群相比,精神疾病患者罹患可预防疾病的风险较高,部分原因是他们的适量运动量(MVPA)较低,而久坐行为(SB)较高。自我决定理论为了解动机如何调节行为提供了一个框架。本研究旨在评估不同形式的体育锻炼动机(无动机、受控动机、自主动机)对精神疾病患者 MVPA 和 SB 的影响:汇总分析了四个国家(澳大利亚、比利时、英格兰和乌干达)一系列精神疾病患者的横断面自我报告和加速度计得出的 MVPA 和 SB。使用运动行为调节问卷(BREQ)测量体育锻炼的动机。在控制心理健康和人口统计学变量的情况下,采用回归分析法研究了 MVPA 和 SB 与非动机、受控动机、自主动机之间的关系:结果:自主动机与自我报告的 MVPA 高 31% 相关,而非自主动机和受控动机分别与自我报告的 MVPA 低 18% 和 11% 相关(n = 654)。相比之下,受控动机与 SB 呈正相关(n = 189)。身体合并症或酗酒与 MVPA 降低有关(n = 318)。对加速计得出的 MVPA 和 SB(n = 139 和 n = 145)进行的子分析未发现与动机形式有任何关联:国际样本的研究结果支持动机在促进健康相关行为中的普遍相关性。医护人员在帮助精神疾病患者进行体育锻炼时,应采用促进自主动机的策略。
{"title":"Which behavioral regulations predict physical activity and sedentary behavior in people with mental illness?","authors":"Justin Chapman, Nicole Korman, Eva Malacova, Caroline Robertson, Urska Arnautovska, Dan Siskind, Shuichi Suetani, Brendon Stubbs, Davy Vancampfort","doi":"10.1017/S0033291724001879","DOIUrl":"10.1017/S0033291724001879","url":null,"abstract":"<p><strong>Background: </strong>Moderate-to-vigorous physical activity (MVPA) is beneficial for health, and reducing sedentary behavior (SB) is recommended in international guidelines. People with mental illnesses are at higher risk of preventable diseases than the general population, partly attributable to lower MVPA and higher SB. Self-determination theory provides a framework for understanding how motivation regulates behavior. This study aimed to evaluate the contribution of different forms of motivation for physical activity (amotivation, controlled, autonomous) to MVPA and SB in people with mental illnesses.</p><p><strong>Methods: </strong>Cross-sectional self-reported and accelerometer-derived MVPA and SB in people with a range of mental illnesses across four countries were pooled for analysis (Australia, Belgium, England, Uganda). Motivation for physical activity was measured using the Behavioural Regulation in Exercise Questionnaire (BREQ). Regression analyses were used to investigate the association of MVPA and SB with amotivation, controlled, autonomous motivations, controlling for mental health and demographic variables.</p><p><strong>Results: </strong>Autonomous motivation was associated with 31% higher self-reported MVPA, and amotivation and controlled motivation were associated with 18% and 11% lower self-reported MVPA, respectively (<i>n =</i> 654). In contrast, controlled motivation was positively associated with SB (<i>n =</i> 189). Having physical comorbidities or an alcohol use disorder was associated with lower MVPA (<i>n</i> = 318). Sub-analyses with accelerometer-derived MVPA and SB (<i>n =</i> 139 and <i>n</i> = 145) did not reveal any associations with motivational forms.</p><p><strong>Conclusions: </strong>Findings with an international sample support the universal relevance of motivation in promoting health-related behavior. Strategies for facilitating autonomous motivation should be utilized by health professionals seeking to support people with mental illnesses to become physically active.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":5.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682651","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
Charting brain GABA and glutamate levels across psychiatric disorders by quantitative analysis of 121 1H-MRS studies. 通过对 121 项 1H-MRS 研究进行定量分析,绘制不同精神疾病大脑 GABA 和谷氨酸水平的图表。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-20 DOI: 10.1017/S0033291724001673
Jiayuan Zhang, Timothea Toulopoulou, Qian Li, Lijing Niu, Lanxin Peng, Haowei Dai, Keyin Chen, Xingqin Wang, Ruiwang Huang, Xinhua Wei, Ruibin Zhang

Background: Psychiatric diagnosis is based on categorical diagnostic classification, yet similarities in genetics and clinical features across disorders suggest that these classifications share commonalities in neurobiology, particularly regarding neurotransmitters. Glutamate (Glu) and gamma-aminobutyric acid (GABA), the brain's primary excitatory and inhibitory neurotransmitters, play critical roles in brain function and physiological processes.

Methods: We examined the levels of Glu, combined glutamate and glutamine (Glx), and GABA across psychiatric disorders by pooling data from 121 1H-MRS studies and further divided the sample based on Axis I disorders.

Results: Statistically significant differences in GABA levels were found in the combined psychiatric group compared with healthy controls (Hedge's g = -0.112, p = 0.008). Further analyses based on brain regions showed that brain GABA levels significantly differed across Axis I disorders and controls in the parieto-occipital cortex (Hedge's g = 0.277, p = 0.019). Furthermore, GABA levels were reduced in affective disorders in the occipital cortex (Hedge's g = -0.468, p = 0.043). Reductions in Glx levels were found in neurodevelopmental disorders (Hedge's g = -0.287, p = 0.022). Analysis focusing on brain regions suggested that Glx levels decreased in the frontal cortex (Hedge's g = -0.226, p = 0.025), and the reduction of Glu levels in patients with affective disorders in the frontal cortex is marginally significant (Hedge's g = -0.172, p = 0.052). When analyzing the anterior cingulate cortex and prefrontal cortex separately, reductions were only found in GABA levels in the former (Hedge's g = - 0.191, p = 0.009) across all disorders.

Conclusions: Altered glutamatergic and GABAergic metabolites were found across psychiatric disorders, indicating shared dysfunction. We found reduced GABA levels across psychiatric disorders and lower Glu levels in affective disorders. These results highlight the significance of GABA and Glu in psychiatric etiology and partially support rethinking current diagnostic categories.

背景:精神疾病的诊断以分类诊断为基础,然而各种疾病在遗传学和临床特征方面的相似性表明,这些分类在神经生物学方面存在共性,尤其是在神经递质方面。谷氨酸(Glu)和γ-氨基丁酸(GABA)是大脑主要的兴奋性和抑制性神经递质,在大脑功能和生理过程中发挥着关键作用:我们汇集了 121 项 1H-MRS 研究的数据,并根据轴 I 疾病进一步划分样本,从而研究了不同精神疾病中 Glu、谷氨酸和谷氨酰胺(Glx)以及 GABA 的水平:结果:与健康对照组相比,综合精神病组的 GABA 水平存在统计学意义上的显著差异(Hedge's g = -0.112,p = 0.008)。基于大脑区域的进一步分析表明,在顶枕皮层,轴一疾病患者和对照组的大脑 GABA 水平存在显著差异(Hedge's g = 0.277,p = 0.019)。此外,情感障碍患者枕叶皮层中的 GABA 水平降低(Hedge's g = -0.468,p = 0.043)。神经发育障碍患者的 Glx 水平降低(Hedge's g = -0.287,p = 0.022)。以大脑区域为重点的分析表明,额叶皮层的 Glx 水平降低(Hedge's g = -0.226,p = 0.025),情感障碍患者额叶皮层的 Glu 水平降低略有显著性(Hedge's g = -0.172,p = 0.052)。在对前扣带回皮层和前额叶皮层进行单独分析时,在所有失调症中仅发现前者的 GABA 水平降低(Hedge's g = - 0.191,p = 0.009):结论:在各种精神障碍中都发现了谷氨酸能和 GABA 能代谢产物的改变,这表明存在共同的功能障碍。我们发现各种精神障碍的 GABA 水平都有所降低,而情感障碍的 Glu 水平较低。这些结果凸显了GABA和Glu在精神病病因学中的重要性,并部分支持了对当前诊断类别的重新思考。
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引用次数: 0
Examining the mental health trajectories of children and adolescents: a cross-cohort analysis. 研究儿童和青少年的心理健康轨迹:交叉队列分析。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-20 DOI: 10.1017/S0033291724001624
Fiona McNicholas, Blanaid Gavin, Ruth Sellers, Iris Ji, Xiaoning Zhang, Wendy V Browne, Gordon Harold

Background: Epidemiological samples provide opportunity to understand the development of mental health trajectories to better understand whether such epidemiological data can help to plan and modify service delivery for youth mental health. Variation between countries is not well understood and thus applying evidence from other countries to national strategies limits support service policy and planning. We therefore examine developmental patterns of youth mental health across different countries using the Growing Up in Ireland (GUI) Cohorts, with comparison to existing UK longitudinal cohort data (Millennium Cohort Study, MCS; Growing up in Scotland, GUS).

Methods: Youth mental health problems within each cohort across development (5-17/18 years) were assessed using parent reported Strengths and Difficulties Questionnaire (SDQ) scores. Using latent growth curve analyses, we examined trajectories of emotional, conduct, and hyperactivity problems for boys and girls, separately for each cohort.

Results: Across cohorts, we observed similar developmental patterns for emotional, conduct, and hyperactivity problems. However, the GUI emotional problems in Ireland emerged earlier than in the UK. By adolescence, GUI emotional scores were similar to the UK, suggesting that the differences in emotional problems between the ROI and UK had narrowed by adolescence. Covariates also had different associations with youth mental health trajectories across cohorts.

Conclusions: Utilizing multiple nationally representative cohort longitudinal datasets can help inform clinically meaningful conclusions and potential recommendations on population level multi-tiered service needs and development in the area of child and adolescent mental health support and future provision.

背景:流行病学样本为我们提供了了解心理健康发展轨迹的机会,从而更好地了解这些流行病学数据是否有助于规划和修改为青少年提供的心理健康服务。我们对各国之间的差异还不甚了解,因此将其他国家的证据应用到国家战略中会限制对服务政策和规划的支持。因此,我们利用在爱尔兰成长(GUI)队列研究,并与现有的英国纵向队列数据(千年队列研究,MCS;在苏格兰成长,GUS)进行比较,研究不同国家青少年心理健康的发展模式:方法:利用家长报告的优势与困难问卷(SDQ)得分,评估每个队列中不同成长阶段(5-17/18 岁)的青少年心理健康问题。通过潜在成长曲线分析,我们分别研究了每个队列中男孩和女孩的情绪、行为和多动问题的轨迹:结果:在不同组群中,我们观察到情绪、行为和多动问题的发展模式相似。然而,爱尔兰的 GUI 情绪问题出现得比英国早。到了青春期,GUI 的情绪得分与英国相似,这表明到了青春期,爱尔兰共和国与英国在情绪问题上的差异已经缩小。各组群的协变量与青少年心理健康轨迹的关系也不尽相同:结论:利用多个具有全国代表性的队列纵向数据集,有助于得出具有临床意义的结论,并就儿童和青少年心理健康支持领域的人群多层次服务需求和发展以及未来提供的服务提出潜在建议。
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引用次数: 0
Adverse psychiatric effects of psychedelic drugs: a systematic review of case reports. 迷幻药对精神病的不良影响:病例报告的系统回顾。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-20 DOI: 10.1017/S0033291724002496
B Yildirim, S S Sahin, A Gee, S Jauhar, J Rucker, P Salgado-Pineda, E Pomarol-Clotet, P McKenna

Background: Psychedelic drugs are a focus of interest in the treatment of depression and other disorders but there are longstanding concerns about possible adverse psychiatric consequences. Because the relevant literature is largely informal, the seriousness of these risks is difficult to evaluate.

Methods: Searches were made for case reports of schizophrenia-spectrum, affective or other psychiatric disorders after use of psychedelic drugs. Case reports of flashbacks were also searched for. Individuals with recent use of other drugs (apart from cannabis and alcohol) and/or a previous history of major psychiatric disorder were excluded. Symptoms were tabulated using the Syndrome Check List of the Present State Examination (PSE-9).

Results: We found 17 case reports of schizophrenia spectrum disorder, 17 of affective disorder (depression, mania, or both), 3 cases of anxiety, 1 of depersonalization, and 1 of unclassifiable illness. The states could develop after a single use of the drug (5/17 schizophrenia; 6/17 affective disorder), and duration was highly variable. Recovery was the rule in cases of affective disorder but not in schizophrenia spectrum disorder. Twelve of 29 cases of flashbacks showed psychiatric symptomatology definitely outlasting the attacks, mainly anxiety (5 cases) and depression (8 cases). Flashback symptoms resolved within twelve months in approximately half of the cases but in a few persisted for years.

Conclusions: Reliable descriptions of schizophrenia spectrum disorder and major affective disorder after psychedelic drug use disorder exist but are relatively uncommon. Flashbacks are sometimes but not always associated with psychiatric symptomatology, mainly anxiety or depression.

背景:迷幻药在治疗抑郁症和其他疾病方面备受关注,但人们长期以来一直担心迷幻药可能会对精神造成不良后果。由于相关文献大多是非正式的,因此很难评估这些风险的严重性:搜索使用迷幻药后出现精神分裂症、情感障碍或其他精神障碍的病例报告。此外,还搜索了有关闪回的病例报告。近期使用过其他药物(大麻和酒精除外)和/或曾有严重精神障碍病史的患者不在搜索之列。我们使用现况检查(PSE-9)的综合症检查表对症状进行了统计:结果:我们发现了 17 例精神分裂症谱系障碍病例报告、17 例情感障碍病例报告(抑郁症、躁狂症或两者兼有)、3 例焦虑症病例报告、1 例人格解体病例报告和 1 例无法分类的病例报告。这些症状可能在使用一次药物后出现(5/17 例精神分裂症;6/17 例情感障碍),持续时间变化很大。情感障碍患者通常会恢复,但精神分裂症谱系障碍患者则不会。在 29 例闪回病例中,有 12 例在发作后出现了精神症状,主要是焦虑(5 例)和抑郁(8 例)。约有一半病例的闪回症状在十二个月内缓解,但也有少数病例的症状持续数年之久:结论:关于使用迷幻药后精神分裂症谱系障碍和重度情感障碍的可靠描述是存在的,但相对并不常见。闪回有时与精神症状(主要是焦虑或抑郁)有关,但并非总是如此。
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引用次数: 0
Effects of aerobic exercise on hippocampal formation volume in people with schizophrenia - a systematic review and meta-analysis with original data from a randomized-controlled trial. 有氧运动对精神分裂症患者海马体形成体积的影响--利用随机对照试验的原始数据进行的系统回顾和荟萃分析。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-18 DOI: 10.1017/S0033291724001867
Lukas Roell, Tim Fischer, Daniel Keeser, Boris Papazov, Moritz Lembeck, Irina Papazova, David Greska, Susanne Muenz, Thomas Schneider-Axmann, Eliska Sykorova, Cristina E Thieme, Bob O Vogel, Sebastian Mohnke, Charlotte Huppertz, Astrid Roeh, Katriona Keller-Varady, Berend Malchow, Sophia Stoecklein, Birgit Ertl-Wagner, Karsten Henkel, Bernd Wolfarth, Wladimir Tantchik, Henrik Walter, Dusan Hirjak, Andrea Schmitt, Alkomiet Hasan, Andreas Meyer-Lindenberg, Peter Falkai, Isabel Maurus

Background: The hippocampal formation represents a key region in the pathophysiology of schizophrenia. Aerobic exercise poses a promising add-on treatment to potentially counteract structural impairments of the hippocampal formation and associated symptomatic burden. However, current evidence regarding exercise effects on the hippocampal formation in schizophrenia is largely heterogeneous. Therefore, we conducted a systematic review and meta-analysis to assess the impact of aerobic exercise on total hippocampal formation volume. Additionally, we used data from a recent multicenter randomized-controlled trial to examine the effects of aerobic exercise on hippocampal formation subfield volumes and their respective clinical implications.

Methods: The meta-analysis comprised six studies that investigated the influence of aerobic exercise on total hippocampal formation volume compared to a control condition with a total of 186 people with schizophrenia (100 male, 86 female), while original data from 29 patients (20 male, 9 female) was considered to explore effects of six months of aerobic exercise on hippocampal formation subfield volumes.

Results: Our meta-analysis did not demonstrate a significant effect of aerobic exercise on total hippocampal formation volume in people with schizophrenia (g = 0.33 [-0.12 to 0.77]), p = 0.15), but our original data suggested significant volume increases in certain hippocampal subfields, namely the cornu ammonis and dentate gyrus.

Conclusions: Driven by the necessity of better understanding the pathophysiology of schizophrenia, the present work underlines the importance to focus on hippocampal formation subfields and to characterize subgroups of patients that show neuroplastic responses to aerobic exercise accompanied by corresponding clinical improvements.

背景:海马形成是精神分裂症病理生理学中的一个关键区域。有氧运动是一种很有前景的附加治疗方法,有可能抵消海马形成的结构损伤和相关症状负担。然而,目前有关运动对精神分裂症海马形成的影响的证据在很大程度上是不一致的。因此,我们进行了一项系统回顾和荟萃分析,以评估有氧运动对海马体形成总体积的影响。此外,我们还利用最近一项多中心随机对照试验的数据,研究了有氧运动对海马形成子野体积的影响及其各自的临床意义:荟萃分析包括六项研究,这些研究调查了有氧运动与对照组相比对海马体形成总体积的影响,共有186名精神分裂症患者(100名男性,86名女性)参与了研究,同时考虑了29名患者(20名男性,9名女性)的原始数据,以探讨六个月的有氧运动对海马体形成子野体积的影响:我们的荟萃分析并未证明有氧运动对精神分裂症患者的海马形成总体积有显著影响(g = 0.33 [-0.12 to 0.77]),p = 0.15),但我们的原始数据表明,某些海马亚领域,即角鞍和齿状回的体积有显著增加:结论:为了更好地理解精神分裂症的病理生理学,本研究强调了关注海马形成亚区的重要性,以及确定对有氧运动表现出神经可塑性反应并伴有相应临床改善的亚组患者的特征。
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引用次数: 0
Regional neural functional efficiency across schizophrenia, bipolar disorder, and major depressive disorder: a transdiagnostic resting-state fMRI study. 跨精神分裂症、双相情感障碍和重度抑郁障碍的区域神经功能效率:一项跨诊断静息态 fMRI 研究。
IF 5.9 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-11-18 DOI: 10.1017/S0033291724001685
Jun Yang, Zhening Liu, Yunzhi Pan, Zebin Fan, Yixin Cheng, Feiwen Wang, Fuping Sun, Guowei Wu, Xuan Ouyang, Haojuan Tao, Jie Yang, Lena Palaniyappan

Background: Major psychiatric disorders (MPDs) are delineated by distinct clinical features. However, overlapping symptoms and transdiagnostic effectiveness of medications have challenged the traditional diagnostic categorisation. We investigate if there are shared and illness-specific disruptions in the regional functional efficiency (RFE) of the brain across these disorders.

Methods: We included 364 participants (118 schizophrenia [SCZ], 80 bipolar disorder [BD], 91 major depressive disorder [MDD], and 75 healthy controls [HCs]). Resting-state fMRI was used to caclulate the RFE based on the static amplitude of low-frequency fluctuation, regional homogeneity, and degree centrality and corresponding dynamic measures indicating variability over time. We used principal component analysis to obtain static and dynamic RFE values. We conducted functional and genetic annotation and enrichment analysis based on abnormal RFE profiles.

Results: SCZ showed higher static RFE in the cortico-striatal regions and excessive variability in the cortico-limbic regions. SCZ and MDD shared lower static RFE with higher dynamic RFE in sensorimotor regions than BD and HCs. We observed association between static RFE abnormalities with reward and sensorimotor functions and dynamic RFE abnormalities with sensorimotor functions. Differential spatial expression of genes related to glutamatergic synapse and calcium/cAMP signaling was more likely in the regions with aberrant RFE.

Conclusions: SCZ shares more regions with disrupted functional integrity, especially in sensorimotor regions, with MDD rather than BD. The neural patterns of these transdiagnostic changes appear to be potentially driven by gene expression variations relating to glutamatergic synapses and calcium/cAMP signaling. The aberrant sensorimotor, cortico-striatal, and cortico-limbic integrity may collectively underlie neurobiological mechanisms of MPDs.

背景:主要精神障碍(MPDs)是根据不同的临床特征划分的。然而,重叠的症状和药物的跨诊断效果对传统的诊断分类提出了挑战。我们研究了这些疾病的大脑区域功能效率(RFE)是否存在共同的和特定疾病的干扰:我们纳入了 364 名参与者(118 名精神分裂症患者 [SCZ]、80 名双相情感障碍患者 [BD]、91 名重度抑郁障碍患者 [MDD] 和 75 名健康对照者 [HCs])。我们使用静息态 fMRI 根据低频波动的静态振幅、区域均匀性和度中心性来计算 RFE,并使用相应的动态测量来显示随时间变化的变异性。我们使用主成分分析来获得静态和动态的 RFE 值。我们根据异常RFE图谱进行了功能和遗传注释及富集分析:结果:SCZ 在皮质纹状体区域显示出较高的静态 RFE 值,而在皮质边缘区域则显示出过大的变异性。与BD和HC相比,SCZ和MDD的静态RFE较低,而感觉运动区的动态RFE较高。我们观察到静态 RFE 异常与奖赏和感觉运动功能相关,而动态 RFE 异常与感觉运动功能相关。在RFE异常的区域,谷氨酸能突触和钙/cAMP信号转导相关基因的空间表达更可能存在差异:结论:与BD相比,SCZ与MDD共享更多功能完整性受损的区域,尤其是感觉运动区。这些跨诊断变化的神经模式似乎可能是由与谷氨酸能突触和钙/cAMP 信号转导有关的基因表达变异驱动的。感觉运动、皮质纹状体和皮质边缘完整性的异常可能是多发性硬化症神经生物学机制的共同基础。
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引用次数: 0
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Psychological Medicine
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