Psychiatry Investigation最新文献

Objective: To investigate the association between adverse childhood experiences (ACEs) and depression in old age, and further examine the moderating role of ACEs on the relationship between later-life disability and depression.

Methods: This study utilizes data from the 2018 China Health and Retirement Longitudinal Study and the 2014 life course survey, employing the binary logistic regression to explore the relationship between ACEs and depression in old age, and applying a multiplicative interaction analysis method to explore the moderating effect of ACEs on the relationship between later-life disability and depression.

Results: The results show a positive association between ACEs and the likelihood of depression in old age (moderate relationship with parents: odds ratio [OR]=1.140, 95% confidence interval [CI] [1.006-1.293]; poor relationship with parents: OR=1.438, 95% CI [1.229- 1.684]; experiencing family stress events: OR=1.214, 95% CI [1.077-1.369]; living in an unsafe community: OR=1.284, 95% CI [1.049- 1.571]; sometimes or often being bullied by peers: OR=1.415, 95% CI [1.188-1.685]). Additionally, the association between later-life disability and depression is significantly weaker among older adults who reported sometimes or often being bullied by peers during childhood, compared to those without such experiences (OR=0.410, 95% CI [0.204-0.826]).

Conclusion: ACEs are positively associated with the likelihood of depression in old age, yet they may also serve a protective role in mental health during later-life severe adversity, such as disability. This protective effect may be attributed to post-traumatic psychological resilience, highlighting the importance of targeted interventions to enhance resilience in individuals exposed to trauma, as well as the integration of trauma-informed care into mental health services for older adults.

Objective: Adverse childhood experiences (ACEs) represent a major public health concern, exerting profound and lasting effects on physical and mental health. However, the burden and specific impacts of ACEs among university students-a population undergoing significant developmental transitions-remain limited. This study aims to address this gap by exploring the prevalence of ACEs and their associations with mental health outcomes and life satisfaction among first-year university students in Vietnam.

Methods: A cross-sectional study was conducted among 1,391 first-year college students in six universities/faculties in Vietnam from August 2021 to August 2022. A questionnaire comprising four components was utilized to collect information from participants. Multivariate linear regression models were employed to identify factors associated with the levels of depression and life satisfaction among participants.

Results: Among 1,391 participants, 54.4% reported experiencing depressive symptoms. Regarding the number of ACEs, 50% of the participants reported that they experienced at least one ACE, and there were 34.8% encountering multiple ACEs (defined as two or more). The study also highlighted the statistical differences in the number of ACEs between depressed individuals and those who did not (p<0.001). The findings revealed a strong correlation between ACEs and the increase in depression levels and poor life satisfaction.

Conclusion: This study highlighted the relatively high prevalence of ACEs and their negative impacts on mental health status and life satisfaction. The results suggest that important strategies such as screening for ACEs and mental health conditions, implementation of community-based programs, and promotion of resilience-focused interventions can play a critical role in mitigating the impact of ACEs, ultimately contributing to healthier individuals and societies.

Objective: The relationship between childhood trauma (CT) and the outcomes of selective serotonin reuptake inhibitor (SSRI) treatment for major depressive disorder (MDD) remains uncertain. The objective of this study is to investigate the overall association between CT and treatment outcomes in patients with MDD and the associations of different CT subtypes with the treatment outcomes of various MDD symptom dimensions.

Methods: A post hoc analysis of 285 adult patients with MDD from a multicenter, prospective study in China. Patients who completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF) and 8-week SSRI treatment were included. Depressive symptoms were evaluated using the 17-item Hamilton Rating Scale for Depression (HRSD-17) at baseline and at 2, 4, and 8 weeks. The primary outcome was defined as the percentage reduction in the total HRSD-17 score at the 8th week. The secondary outcomes included the percentage reduction in anhedonia and insomnia, derived from the HRSD-17. Linear regression analyses were conducted to evaluate the associations between the CTQ-SF score and treatment outcomes.

Results: Emotional neglect (EN) was associated with lower percentage reductions in HRSD-17 scores (β=-3.035, p=0.019), anhedonia (β=-4.227, p=0.044) and insomnia (β=-7.054, p=0.045) at 8 weeks. The total CTQ-SF score and other subscale scores were not significantly associated with treatment outcomes.

Conclusion: EN was associated with poorer SSRI treatment outcomes in MDD patients, with less improvement in overall depressive symptoms and anhedonia and insomnia in particular. EN should be prioritized in MDD treatment.

Objective: The Lebanese people have endured through several disasters, such as the Beirut explosion, coronavirus pandemic, and cholera outbreak. However, volunteers who have tried to overcome such national disasters develop emotional stress after witnessing people's death. This study was conducted to explore whether volunteers' depression or anxiety mediates the relationship between grief response and post-traumatic stress disorder (PTSD) symptoms.

Methods: We conducted an anonymous online survey study and collected responses from 270 volunteers in Lebanon from March 20-26, 2023. Demographic information and responses to the questionnaires, which included the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5), Public Service Motivation scale (PSM scale), Connor-Davidson Resilience Scale-2, and Prolonged Grief Disorder (PG-13) were collected. Variables were compared between volunteers who did and did not witness people's death. Furthermore, we explored the relationships among variables in volunteers who witnessed people's death (n=72).

Results: Among 270 participants, 72 (26.67%) witnessed people's death. The regression model demonstrated that scores for PG-13 (β= 0.31, p<0.001), PHQ-9 (β=0.21, p=0.011), and GAD-7 (β=0.44, p<0.001) were predictors of the PCL-5 score. Mediation analysis showed that grief reaction directly influenced PTSD symptoms (Z=6.19, p<0.001), whereas depression (Z=1.99, p=0.047) and anxiety (Z=2.79, p=0.005) individually mediated the relationship between grief reaction and PTSD symptoms.

Conclusion: Our study helps understand the mediating effects of volunteers' depression or anxiety on the relationship between grief reactions and PTSD symptoms.

Objective: Based on the neuroimmunological hypothesis of major depressive disorder (MDD), we analyzed the existing research to identify cytokine-related genes associated with MDD. Furthermore, we examined the cytokine alterations in patients with MDD as potential biomarkers for diagnosis and monitoring.

Methods: Differentially expressed genes (DEGs) related to MDD were identified using the GEO2R tool on public datasets, followed by functional enrichment analyses with Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathways. Protein-protein interaction (PPI) networks were constructed using Cytoscape to identify hub genes. Finally, blood samples from 20 patients with MDD and 10 healthy controls were analyzed using the Olink® Target 96 Inflammation panel with proximity extension assay (PEA) technology to identify potential protein biomarkers.

Results: Two GEO datasets related to MDD were analyzed to identify 66 common DEGs. Following the PPI analysis, 46 genes were identified. Functional enrichment analysis revealed that these genes were closely related to immune-related pathways. Subsequent blood sample analysis of patients with MDD and healthy controls confirmed that 18 cytokines related to 46 DEGs were significantly upregulated. Among the identified cytokines, oncostatin M (OSM) showed the highest receiver operating characteristic (ROC) performance (area under the curve [AUC]=0.96), followed by hepatocyte growth factor (HGF) (AUC=0.95), cluster of differentiation 6 (CD6) (AUC=0.90), and tumor necrosis factor superfamily 14 (TNFSF14) (AUC=0.90).

Conclusion: Our study confirms that neuroinflammation is an important pathophysiological aspect of MDD and that several related cytokines, such as OSM, HGF, CD6, and TNFSF14, may be potential biomarkers of MDD.

Objective: This study aimed to investigate the effects of the mindful somatic psychoeducation program (MSPP) on the mental health of unmarried mothers.

Methods: Sixteen unmarried mothers with children aged 0-5 years were randomly assigned to an intervention group (IG, n=8) or control group (CG, n=8). The IG participated in an 8-week MSPP, while the CG maintained their usual routines. Pre- and post-assessments included the Resilience Quotient (RQ), Hospital Anxiety and Depression Scale (HADS), and Physical Self-Description Questionnaire. Quantitative data were analyzed using Wilcoxon signed-rank and Mann-Whitney U tests. Qualitative interviews were analyzed using Giorgi's phenomenological method.

Results: The IG showed significant improvements in self-regulation, positivity, and overall resilience (p<0.05). Anxiety and depression levels significantly decreased (p<0.05), and self-esteem improved (p<0.05), while no significant changes were found in the CG. Qualitative findings revealed: 1) changes in the soma (e.g., improved posture, pain relief), 2) enhanced mind-body integration (e.g., emotional regulation through breath and movement), and 3) increased mindfulness and self-regulation (e.g., reduced self-blame, improved parenting responses).

Conclusion: This study confirmed that MSPP helps unmarried mothers experience positive changes in physical, psychological, and social variables. These results serve as empirical foundational data for expanding the application areas of the MSPP and for research aimed at promoting the health of unmarried mothers.

Objective: This study aimed to improve the prediction of treatment response in patients with posttraumatic stress disorder (PTSD) by applying a variational autoencoder (VAE)-based data augmentation (DA) approach to electroencephalogram (EEG) data.

Methods: EEG spectrograms were collected from patients diagnosed with PTSD. A VAE model was pretrained on the original spectrograms and used to generate augmented data samples. These augmented spectrograms were then utilized to train a deep neural network (DNN) classifier. The performance of the model was evaluated by comparing the area under the receiver operating characteristic curve (AUC) between models trained with and without DA.

Results: The DNN trained with VAE-augmented EEG data achieved an AUC of 0.85 in predicting treatment response, which was 0.11 higher than the model trained without augmentation. This reflects a significant improvement in classification performance and model generalization.

Conclusion: VAE-based DA effectively addresses the challenge of limited EEG data in clinical settings and enhances the performance of DNN models for treatment response prediction in PTSD. This approach presents a promising direction for future EEG-based neuropsychiatric research involving small datasets.

Objective: This study investigated the relationships among interoceptive awareness, difficulties in emotion regulation, and alexithymia in a group of outpatients undergoing consultation liaison psychiatry (CLP).

Methods: Three hundred forty outpatients who applied to the Consultation Liaison Psychiatry Department were included in the study. Thirty-four patients who did not complete the questionnaires for various reasons were excluded from the study. Multidimensional Interoceptive Awareness (MAIA-2), Difficulties in Emotion Regulation Scale (DERS-16), and Toronto Alexithymia Scale (TAS-20) were applied to the participants. Statistics were performed with SPSS 21.0. Mediation analysis examined the relationship between interoceptive awareness, difficulties in emotion regulation, and alexithymia.

Results: It was found that 32% of outpatients who applied to CLP exhibited high alexithymic features. According to the study's results, interoceptive awareness had a significant negative relationship with difficulty in emotion regulation (r=-0.487, p<0.001). According to mediation analysis, difficulty in emotion regulation mediated the relationship between interoceptive awareness and alexithymia (β=-0.313; 95% confidence interval, -0.405 to -0.227; p<0.001).

Conclusion: This study demonstrated the mediating effect of emotion regulation difficulties on the relationship between interoceptive awareness and alexithymia in outpatients applying to CLP. The use of interoception-based practices by mental health professionals working with CLP may reduce emotion control and alexithymia symptoms in this patient group.

Objective: Late adolescence and young adulthood are crucial periods when individuals rely on family support to navigate challenges like identity formation and career decisions. Supportive families aid in coping during this transition. This study examines the links between family quality of life (FQoL), goal attainment, and psychological distress in the Pakistani cultural context.

Methods: Of the 300 students in this cross-sectional study, 52.0% were men, and 48.0% were women. The study employed the Beach Centre Family Quality of Life Scale to assess students' well-being within a familial context, the Depression, Anxiety, and Stress Scale-21 to measure psychological distress, and the Goal Achievement Questionnaire (goal achievement mastery [GA-M] and goal achievement performance [GA-P]) to evaluate goal orientation.

Results: GA-M was negatively associated with depression, stress, family interaction, and parenting but positively linked to anxiety. Conversely, GA-P was positively associated with psychological distress. Women students scored higher on GA-P (t(298)=-3.41, p<0.001). In contrast, men scored higher on Physical/Material Well-being (t(298)=2.35, p<0.01). Additionally, FQoL positively predicted GA-P via depression and stress but negatively predicted GA-M via depression and stress.

Conclusion: FQoL is closely linked to students' GA-M and GA-P, with depression and stress as indirect mediators. These findings underscore the critical role of familial support in shaping goal achievement.