Psychiatry Investigation最新文献

Objective: The rapid societal changes have underscored the importance of effective stress detection and management. Chronic mental stress significantly contributes to both physical and psychological illnesses. However, many individuals often remain unaware of their stress levels until they face physical health issues, highlighting the necessity for regular stress monitoring. This study aimed to investigate the effectiveness of vocal biomarkers in detecting stress levels among healthy Korean employees and to contribute to digital healthcare solutions.

Methods: We conducted a multi-center clinical study by collecting voice recordings from 115 healthy Korean employees under both relaxed and stress-induced conditions. Stress was induced using the socially evaluated cold pressor test. The Emphasized Channel Attention, Propagation and Aggregation in Time delay neural network (ECAPA-TDNN) deep learning architecture, renowned for its advanced capabilities in analyzing person-specific voice features, was employed to develop stress prediction scores.

Results: The proposed model achieved a 70% accuracy rate in detecting stress. This performance underscores the potential of vocal biomarkers as a convenient and effective tool for individuals to self-monitor and manage their stress levels within digital healthcare frameworks.

Conclusion: The findings emphasize the promise of voice-based mental stress assessments within the Korean population and the importance of continued research on vocal biomarkers across diverse linguistic demographics.

Objective: Danshensu, a phenylpropanoid compound, is derived from the dry root and rhizome of Danshen (Salvia miltiorrhiza), a traditional Chinese medicinal herb. Evidence suggests that danshensu protects isolated rat hearts against ischemia/reperfusion injury by activating the protein kinase B (Akt)/extracellular signal-regulated kinase (ERK) pathway or by inhibiting autophagy and apoptosis through the activation of mammalian target of rapamycin (mTOR) signaling. Furthermore, danshensu promotes the postischemic regeneration of brain cells by upregulating the expression of brain-derived neurotrophic factor (BDNF) in the peri-infarct region. However, basic and clinical studies are needed to investigate the antidepressant effects danshensu and determine whether brain mTOR signaling and BDNF activation mediate these effects. The aforementioned need prompted us to conduct the present study.

Methods: Using a C57BL/6 mouse model, we investigated the antidepressant-like effects of danshensu and the mechanisms that mediate these effects. To elucidate the mechanisms, we analyzed the roles of Akt/ERK-mTOR signaling and BDNF activation in mediating the antidepressant-like effects of danshensu.

Results: Danshensu exerted its antidepressant-like effects by activating the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) of Akt/ERK-mTOR signaling and promoting BDNF release. Treatment with danshensu increased the level of glutamate receptor 1 phosphorylation at the protein kinase A site.

Conclusion: Our study may be the first to demonstrate that the antidepressant effects of danshensu are dependent on the activation of the AMPAR-mTOR signaling pathway, are correlated with the elevation of BDNF level, and facilitate the insertion of AMPAR into the postsynaptic membrane. This study also pioneers in unveiling the potential of danshensu against depressive disorders.

Objective: This study aims to explore the association between work-related stress of healthcare workers in response to the coronavirus disease-2019 (COVID-19) pandemic and their depressive symptoms. Additionally, it focuses on the impact of insomnia symptoms, interpersonal factors, and resilience on depressive symptoms.

Methods: The results of an anonymous survey of 329 healthcare workers were analyzed, including the Stress and Anxiety to Viral Epidemics-3 items, Insomnia Severity Index, Interpersonal Needs Questionnaire, Connor-Davidson Resilience Scale-2 items, and Patient Health Questionnaire-9 items. Mediation analysis assessed whether insomnia symptoms, resilience, and interpersonal factors mediate the association between work-related stress and depressive symptoms.

Results: Work-related stress directly influenced depressive symptoms (standardized estimator=0.11, p=0.010, 95% confidence interval [CI] 0.03-0.19). The association between the former and latter was positively mediated by insomnia symptoms (standardized estimator=0.10, p<0.001, 95% CI 0.05-0.14), thwarted belongingness (standardized estimator=0.04, p=0.006, 95% CI 0.01-0.07), and perceived burdensomeness (standardized estimator=0.05, p=0.002, 95% CI 0.02-0.08) and was negatively mediated by resilience (standardized estimator=0.02, p=0.041, 95% CI 0.0001-0.04).

Conclusion: This study highlights the connection between heightened work-related stress experienced by healthcare workers amid the COVID-19 pandemic and the subsequent development of depressive symptoms mediated by insomnia, interpersonal factors, and resilience. Interventions that focus on building resilience could be pivotal in mitigating the detrimental mental health consequences of workplace stress among healthcare workers in a viral epidemic.

Objective: This study aimed to elicit expert consensus on the necessary components of a seclusion room module required to accommodate and manage psychiatric emergency patients requiring both medical and surgical interventions in infectious disease situations.

Methods: A two-round Delphi survey was conducted among 38 medical professionals, architects, and spatial design experts. The survey assessed the effectiveness, feasibility, and urgency of spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room.

Results: In the spatial scale domain, items such as "sufficient width to comply with disability standards (wheelchair accessible)" and "larger space should be provided for patients with a large range of motion or requiring special medical procedures" emerged as priorities. In the movement system domain, priorities included "anticipating situations where stable patients need to be pushed on a stretcher cart from both sides, necessitating a wider passage." In the spatial organization domain, priorities included "installing interior elements (wall images, media panels, etc.) that aid patient stability, although a separate area for patients' activities reflecting psychiatric characteristics is not necessary."

Conclusion: Expert consensus was achieved regarding the spatial scales, spatial organization, and movement system domains related to the necessary elements of a seclusion room for psychiatric emergency patients.

Objective: Infertility, the inability to achieve pregnancy within a year despite normal attempts to conceive without contraception, causes psychosocial burden for individuals and couples. This review summarized the interrelationship between infertility and psychological stress and suggested various forms of psychological intervention for infertility.

Methods: The PubMed, Google Scholar, and Korean Studies Information Service System databases were searched for English- and Korean-language articles published from 1990 to 2024.

Results: Infertility leads to emotional distress from diagnosis to treatment. Also, psychological stress affects the trajectory of infertility. This distress may cause psychiatric illnesses, negatively affecting pregnancy. Psychotherapies, psychopharmacotherapies, and biological treatments can be used for the management of psychiatric illnesses in infertile patients. Digital therapeutics also have the potential to be a competitive treatment option.

Conclusion: Regular assessment and management of psychological stress in infertile couples are essential during the course of infertility treatment. Psychological intervention of infertile patients should be implemented according to a personalized plan that completely reflects the individual clinical characteristics.

Objective: Neuroinflammation's role is increasingly emphasized in the pathology of major depressive disorder (MDD), and its close association with the risk of suicide is being reported. The Forkhead Box O1 (FoxO1) gene is known to play a role in regulating mood and emotion and is associated with susceptibility to suicidality in relation to environmental stress. This research aims to explore the relationship between FoxO1 and the risk of suicide in individuals with MDD.

Methods: We enrolled 127 healthy controls (HC) and 231 patients diagnosed with MDD, including 119 individuals with high suicide risk (HSR). All participants underwent the Hamilton Rating Scale for Depression Assessment and magnetic resonance imaging. Cortical thickness and white matter integrity were evaluated.

Results: In the HSR group, cortical thinning was observed in the left triangular part of the inferior frontal gyrus and right transverse frontopolar gyrus compared to HC. Additionally, fractional anisotropy (FA) values were decreased in the left posterior thalamic radiation, sagittal stratum, and uncinate fasciculus. Although no differences were observed based on allele variations for the two FoxO1 single nucleotide polymorphisms (SNPs), those with the minor allele of FoxO1 rs34733279, especially in the HSR group, displayed increased cortical thinning and reduced FA values in the left cingulum.

Conclusion: Our study reveals close association between the minor allele of the FoxO1 gene rs34733279 and suicide risk in the left cingulum highlights the potential key role of the FoxO1 gene rs34733279 in the context of suicidal vulnerability. Further investigations are warranted to elucidate the underlying biological mechanisms.

Objective: The study compared differences in various neurocognitive characteristics across treatment modalities among schizophrenia patients recruited in one city between July 2020 and June 2023 who were on regular medication.

Methods: Of the 151 participants, 113 were included in the analysis. Participants were divided into community-based and hospital-based groups, and their demographics and clinical characteristics, including insight, quality of life, positive and negative symptoms, and personal and social functioning, were examined. In addition, several aspects of cognition were assessed using neurocognitive assessments such as the Trail Making Test (TMT), Stroop test, and Wisconsin Card Sorting Test (WCST). After adjusting for age differences between groups, the final analysis included data from 42 participants in the community-based group and 33 participants in the hospital-based group.

Results: Hospital-based group participants completed Stroop-W more rapidly, excelled in Rey-Osterrieth Complex Figure Test recall and recognition, and incurred fewer TMT Part B (TMT-B) and Stroop-C errors. Additionally, they outperformed in WCST total, non-persistent errors, and categories completed. Contrastingly, community-based group participants showed superior outcomes in WCST persistent responses and errors, suggesting specific neurocognitive strengths.

Conclusion: We found differences in neurocognitive characteristics between the two groups. These differences were consistent across a range of cognitive domains, including attention, visual discrimination, memory, and executive functioning. Further large-scale study is needed to generalize cognitive characteristics across treatment modalities.

Objective: Suicide is a significant public health issue, with South Korea having the highest suicide rate among Organisation for Economic Cooperation and Development countries. This study aimed to develop clinical guidelines for suicide prevention in psychiatric patients in Korea using the ADAPTE methodology.

Methods: The development process involved a comprehensive review of literature, expert consultations, and consensus-building using the Nominal Group Technique and Delphi method. The guidelines focus on evidence-based psychiatric treatments, including both pharmacological and non-pharmacological approaches, tailored to the Korean context. Key findings underscoring the need for standardized treatment protocols for patients with major psychiatric disorders, including bipolar disorder, major depressive disorder, and schizophrenia.

Results: The guidelines incorporate treatments like lithium, clozapine, atypical antipsychotics, electroconvulsive therapy, and cognitive behavioral therapy, which have shown effectiveness in suicide prevention. Applicability and acceptability within Korea's healthcare system were addressed, ensuring feasibility given the country's medical insurance coverage and accessibility. The guidelines were validated through expert reviews and Delphi rounds, achieving consensus on the final recommendations.

Conclusion: The developed guidelines provide a structured, evidence-based approach to reducing suicide rates among psychiatric patients in Korea. Future research will focus on expanding these guidelines to include screening protocols for high-risk groups.

Objective: To date, the feasibility of autonomous sensory meridian response (ASMR) as a complement to traditional treatments for patients with depression remains unclear. The main objective of this study was to investigate the effects of breathing-relaxation training plus ASMR on mood and depressive symptoms in patients with mild depression.

Methods: A quasi-experimental pre- and post-test design with a non-equivalent control group was used. Forty patients with mild depression were assigned to the experimental group that received breathing-relaxation training plus ASMR or the wait-list control group for a total of 8 training sessions. To assess mood and depressive symptoms, the Korean version of the Profile of Mood State-Brief and the Patient Health Questionnaire-9 were performed.

Results: There was no significant difference in baseline demographic characteristics between both groups. After the 8 training sessions, the experimental group achieved a significantly greater improvement in mood and depressive symptoms with more ASMR experiences compared to the control group.

Conclusion: These findings illustrated the feasibility of ASMR as a complementary tool and breathing-relaxation training plus ASMR might be clinically beneficial to alleviate negative mood and depressive symptoms in patients with mild depression.

Objective: The coronavirus disease-2019 (COVID-19) pandemic has had a severe impact on mental health. To explore the underlying mechanisms that influence mental health, a critical question is whether different types of coping strategies may mediate the relationships between COVID-19 related stress and mental health.

Methods: Recruited between October 19 and 24, 2021, a total of 500 participants aged 20 to 69 years completed an online survey to evaluate the COVID-19 stress, coping orientation, depression and state anxiety. The period corresponded to the highest level of COVID-19 restrictions (level 4) immediately before the adjusted restriction to level 3. Parallel mediation analyses were conducted using structural equation modeling.

Results: Distinct mediation effects of the COVID-19 stress (i.e., fear of infection, difficulties of social distancing, anger toward others) through three types of coping strategies (i.e., functional, dysfunctional, seeking support) were found. Fear of infection was likely to be related to functional coping and dysfunctional coping. Social distancing model indicated dysfunctional coping and seeking support, while anger toward others model was associated with functional coping and seeking support.

Conclusion: The results highlight the different relationships between COVID-19 stress and mental health coping strategies. The identification of these mediation pathways offers guidance for designing effective interventions and support systems to promote psychological well-being during challenging times like the COVID-19 pandemic.