Psychiatry Investigation最新文献

Objective: This study aims to identify the cognitive and psychological characteristics associated with suicide attempts in young adults with major depressive disorder (MDD).

Methods: The study involved 49 young adults aged 19-29 years diagnosed with MDD (28 attempters and 21 non-attempters) who visited psychological tests were retrospectively conducted. Additionally, data were collected from a healthy control (HC) group of 49 individuals, matched for age and gender, who were screened from the community. The Korean Beck Depression Inventory-2, Korean Reasons for Living Inventory, Korean Wechsler Adult Intelligence Scale-IV (K-WAIS-IV), Minnesota Multiphasic Personality Inventory-2 (MMPI-2) were used to assess psychological factors. Kruskal-Wallis was conducted to compare the mean differences among the three groups in each test.

Results: In the K-WAIS-IV, individuals with attempters and non-attempters exhibited significantly lower performance in the Full-Scale Intelligence, Perceptual Reasoning Index, and Processing Speed Index compared to the HCs. The MMPI-2 revealed significant differences between the suicide attempt and non-suicide attempt groups in scales Hypomanic Activation (RC9), Anger (ANG), Antisocial Practices (ASP), Social Responsibility (Re), MacAndrew's Alcoholism-Revised, Addiction, and Disconstraint (DISC).

Conclusion: Young adults with MDD who attempted suicide are characterized by heightened externalized psychological issues such as anger, impulsivity, and lack of control. This study provides clinical implications for reducing suicide risk and improving mental health among young adults with MDD.

Objective: The prevalence of depression is high among patients with end stage kidney disease (ESKD). To date, there has been limited investigation into the comparative effects of antidepressant in patients with ESKD. This study aims to explore the association between type of antidepressant, incidence of all-cause death, and hospitalization for major bleeding in patients with ESKD and depression.

Methods: This study utilized data obtained from the Korean National Health Insurance Service Database. Patients with ESKD were divided into two groups: those prescribed strong serotonin reuptake inhibitors (SRIs) and those prescribed weak or intermediate SRIs.

Results: Over a mean follow-up of 2.46 years, the strong SRI group had a lower risk of all-cause death (hazard ratio [HR] 0.87, 95% confidence interval [CI] 0.81-0.93) and hospitalization for major bleeding (HR 0.84, 95% CI 0.79-0.90) with no increased risk of bleeding-related death (HR 1.05, 95% CI 0.80-1.37) compared to the weak or intermediate SRI group. The protective effects of strong SRI use for all-cause death and hospitalization for major bleeding remained consistent in those prescribed SSRIs for less than 120 days (death: HR 0.85, 95% CI 0.80-0.92; hospitalization for major bleeding: HR 0.84, 95% CI 0.78-0.90), and in patients aged below 75 years (death: HR 0.83, 95% CI 0.76-0.90; hospitalization for major bleeding: HR 0.81, 95% CI 0.75-0.87).

Conclusion: In patients with ESKD and depression, the use of strong SRIs was associated with a reduced risk of all-cause death and major bleeding hospitalization compared to the use of weak or intermediate SRIs.

Objective: Although depression is a common comorbidity in children with attention-deficit/hyperactivity disorder (ADHD), its neurophysiological relationship according to each symptom has rarely been explored. This study aimed to inform clinical practice by exploring the neurophysiological underpinnings of depression comorbidity in ADHD.

Methods: We conducted a cross-sectional study of 87 children with ADHD (68 males). Resting quantitative electroencephalography (qEEG) recordings were collected with eyes closed. We used various questionnaires to evaluate ADHD symptoms severity, depression, and anxiety. Pearson correlation coefficients were used to investigate the relationship between the z-score relative spectral power of qEEG and each psychological symptom. Data were analyzed using IBM SPSS 27.0.

Results: The study's findings indicated that theta activity at the frontal, central, and parietal locations had a negative correlation with the severity of ADHD symptoms in children diagnosed with ADHD. In contrast, alpha activity in these same regions demonstrated a positive correlation with ADHD symptom severity. Additionally, delta activity in the regions was negatively correlated with depression severity.

Conclusion: These findings suggest that alpha and theta activity might serve as a reliable neurophysiological marker of ADHD symptom severity, while delta activity might function as a reliable biological marker of depression severity in children with ADHD. However, further research is needed to generalize the results of this study.

Objective: This study investigates the impact of changes in physical activity (PA) on the risk of developing dementia in individuals diagnosed with depression, using a large-scale, retrospective national cohort dataset.

Methods: Using a cohort data from the National Health Insurance of South Korea, 1,291,706 clinically depressed subjects were analyzed to assess the relationship between PA and dementia onset. Subjects were classified into four groups-"never," "beginning," "discontinuation," or "maintenance"-based on their PA status before and after the diagnosis of depression. Hazard ratios with confidence intervals were calculated to determine the risk across different PA status groups.

Results: Among the total sample, 58,934 (4.56%) were newly diagnosed with dementia during the follow-up period. Our findings demonstrated that those who maintained PA post-diagnosis had the lowest risk of developing dementia. Also, beginning PA post-diagnosis is associated with a significantly lower risk of developing dementia compared to those who remained inactive or discontinued PA. Subgroup analyses indicated that the protective effect of PA against dementia is more pronounced in women than in men.

Conclusion: Consistent engagement in PA, particularly after the onset of depression, is associated with a reduced risk of dementia. These findings underscore the importance of PA as a potential intervention for mitigating cognitive decline in depressed individuals.

Objective: This study aimed to examine the associations between age group, alcohol drinking status, and the development of posttraumatic stress disorder (PTSD) over a 2-year period in individuals who have sustained physical injuries.

Methods: Participants were consecutively recruited from a trauma center and prospectively followed for 2 years. At baseline, alcohol drinking status was assessed using consumption history and the Alcohol Use Disorders Identification Test (AUDIT). Age was categorized into younger (<60 years) and older (≥60 years) groups. A range of socio-demographic and clinical covariates were also collected. PTSD diagnosis during follow-up (3-, 6-, 12-, and 24-month post-injury) was established using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Binary and multinomial logistic regression analyses explored the relationships between alcohol drinking status, age group, and PTSD.

Results: Of 1,047 participants, 122 (11.7%) developed PTSD: 8.2% at 3 months, 7.2% at 6 months, 4.7% at 12 months, and 3.8% at 24 months. Younger age was significantly associated with PTSD. While alcohol use alone wasn't linked to PTSD, it modified the age-PTSD relationship. This effect was weaker in hazardous drinkers (AUDIT ≥8) and stronger in low-risk drinkers (AUDIT <8), particularly at later follow-ups (6-24 months), but not at 3 months.

Conclusion: A significant alcohol-dependent association between age and PTSD highlights the need for targeted prevention strategies considering both alcohol use and age in physically injured individuals.

Objective: Interleukin (IL)-40 is a recently identified cytokine implicated in inflammatory diseases. Increasing evidence links anxiety disorders to heightened inflammation. This study aimed to investigate IL-40 levels and oxidative stress in patients with generalized anxiety disorder (GAD).

Methods: Fourty-four patients with GAD and 44 healthy controls were recruited for this study. All patients were assessed for severity of anxiety symptoms using the Hamilton Anxiety Rating Scale (HAM-A).

Results: The serum IL-40 levels were observed to be elevated in patients diagnosed with GAD in comparison to healthy controls (p<0.001). A significant positive correlation was observed between IL-40 and HAM-A scores (r=0.329, p=0.029). IL-40 demonstrated predictive value in receiver operating characteristic analysis, with an area under the curve value of 0.871 (p=0.001). The levels of native thiol and total thiol were found to be significantly lower, while the levels of disulfide were significantly higher in comparison to the control group (p<0.001, p=0.001, p=0.027, respectively). However, IL-40 levels showed no significant correlation with oxidative stress markers, including native thiol, total thiol, and disulfide levels.

Conclusion: This is the first study to explore the potential relationship between IL-40 and the pathophysiology of GAD. The observed elevation in IL-40 levels may reflect a possible immune regulatory imbalance in GAD. While these findings suggest that IL-40 could be a candidate biomarker for further investigation, their clinical utility for diagnosis or monitoring remains speculative. Additional large-scale and longitudinal studies are required to confirm these preliminary observations and to better understand the immunological aspects of GAD.

Objective: Considering the established intertwined relationships between burnout and other psychiatric disorders, this study aimed to clarify the existing levels of depression, anxiety, stress, emotional exhaustion, depersonalization, and personal accomplishment and their relationship among oncologists-a seemingly professional group at risk for mental health issues development.

Methods: A cross-sectional observational study was conducted in January 2024, involving 159 oncologists from Serbia and the Serbian Republic. Participants completed an online questionnaire assessing socio-demographic characteristics and working conditons, depression, anxiety, stress, and burnout using validated scales-the Depression Anxiety Stress Scale-21 and the Maslach Burnout Inventory-Human Services Survey.

Results: Results indicate that respondents were mildly depressed, moderately anxious, and mildly stressed overall. Regarding three dimensions of burnout respondents have moderate emotional exhaustion, depersonalization, and low personal accomplishment. No significant differences were found in depression, anxiety, and stress among medical, surgical, and radiation oncologists. Whether the respondents are seeing a psychiatrist and/or undergoing psychiatric therapy was predictive of depression, anxiety, and stress. Economic status was predictive for depression and stress, while an additional predictive factor of anxiety was the presence of somatic illness. Further analysis showed depression and stress levels can be predicted by all three dimensions of burnout, whereas anxiety levels can be predicted by the level of depersonalization.

Conclusion: These findings emphasize the complex interplay between burnout and other mental health disorders in oncologists, highlighting the need for targeted mental health interventions and support systems within the oncology field to mitigate the psychological toll on these physicians.

Objective: To investigate the pattern of antipsychotic drug use and safety in patients with bipolar disorder (BD).

Methods: A retrospective analysis was conducted using a convenience sampling method to collect medical records of 150 BD patients who attended our psychiatric outpatient clinic from July to December 2023. The treatment and follow-up period lasted for 12 months. Based on the use of antipsychotics during the follow-up period, patients were categorized into three subgroups: typical antipsychotics only atypical antipsychotics only, and concurrent use of both antipsychotics. Their medication use, adverse effects, and specific observation indicators including the number of antipsychotics used, the percentage of anticholinergics used, the incidence of somatic discomfort, cognitive impairment, memory loss, and decreased attention were compared.

Results: There was no statistically significant difference between the three groups in terms of gender, age, whether they worked or not, and comorbidities (p>0.05); the difference between the three groups was statistically significant in terms of the percentage of the number of antipsychotics used and the percentage of anticholinergics used (p<0.001), and there was no statistically significant difference in terms of the percentage of other adjunctive psychotropic medications or the percentage of the use of traditional Chinese medicines (p>0.05); during the follow-up period, all three groups of patients had symptoms of somatic discomfort, cognitive impairment, memory loss, and decreased attention, but the difference in their incidence was not statistically significant (p>0.05); moreover, none of the three groups of patients had impairments of liver and kidney functions during the follow-up period.

Conclusion: Antipsychotics play a crucial role in treating BD patients. This study provides insights into optimizing treatment strategies by highlighting the importance of considering both safety and efficacy when prescribing antipsychotics.

Objective: The global impact of respiratory infectious diseases led to significant mental health challenges, highlighting the need for proactive psychological interventions to prepare for future pandemics. In response, virtual reality-based stabilization (VRS) was developed to mitigate posttraumatic stress symptoms (PTSS) and related comorbidities.

Methods: This study evaluated and predicted the effectiveness of VRS in 43 coronavirus disease-2019 (COVID-19) survivors and healthcare workers from COVID-19 treatment units. The effectiveness of VRS, conducted over five sessions, was measured using preand post-intervention psychological assessments for PTSS, depression, anxiety, COVID-related fear, posttraumatic growth, and quality of life. Additionally, a machine learning model was used to predict the impact of the intervention on PTSS and depression based on preintervention psychological assessments and heart rate variability tests.

Results: The post-intervention results showed significant improvements in all psychological outcomes. The machine learning-based model demonstrated good predictive accuracy for changes in PTSS and depression (R2=0.414-0.723). Notably, individuals with higher pre-intervention scores for PTSS and related comorbidities, as well as elevated heart rate variability and younger age, exhibited more significant improvements.

Conclusion: These findings suggest that VRS is effective in addressing PTSS and related conditions, and incorporating clinical and demographic data can enhance prediction models, enabling more personalized intervention strategies.

Objective: Depression is a prevalent psychiatric disorder posing significant global public health challenges. Although traditional antidepressants are widely used, their full therapeutic effects typically require prolonged administration, which may compromise patient outcomes. To enhance treatment efficacy and patient well-being, identifying rapidly acting and safe therapeutic agents is critical. Oxytocin, an endocrine polypeptide hormone, has shown therapeutic potential in depression by modulating physiological, cognitive, and social behaviors via central and peripheral mechanisms.

Methods: This review was conducted using the PubMed and Web of Science databases without time restrictions. It provides the first systematic synthesis of empirical evidence on the oxytocin's therapeutic efficacy across depressive disorders, comprehensively describes its potential neurobiological targets, and rigorously evaluates its therapeutic mechanisms. Data from randomized controlled trials were analyzed to assess the clinical feasibility and scientific validity of oxytocin.

Results: Evidence from included studies suggested that oxytocin enhanced maternal perception of infants in females with postpartum depression, although its impact on maternal mood was inconsistent. Oxytocin demonstrated efficacy as an adjunctive therapy to psychotherapy or pharmacotherapy in major depressive disorder and treatment-resistant depression. Additionally, studies identified sex differences in oxytocin's antidepressant effects.

Conclusion: The present study provides a comprehensive summary of oxytocin's antidepressant effects, offers new insights into its use for treating diverse subtypes of depression, and presents useful guidance for developing evidence-based depression treatment protocols.