Psychiatry Investigation最新文献

Objective: The aim of the study is to evaluate the efficacy of a karaoke-based digital therapeutic program (CogniSong) in patients with mild cognitive impairment (MCI).

Methods: In a 12-week single-center, assessor-blinded randomized controlled trial, 36 patients with MCI were randomly assigned to either the CogniSong digital therapeutics (DTx) group (n=18) or standard treatment group (n=18). The intervention group underwent daily 30-minute karaoke game-based cognitive training sessions via a mobile application. The primary outcome was the change in Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) total score from baseline to week 12. Secondary outcomes included RBANS subdomain index scores, the Seoul-Instrumental Activities of Daily Living, 17-item Hamilton Depression Rating Scale, Neuropsychiatric Inventory, and Clinical Dementia Rating-Sum of Boxes.

Results: The DTx group showed a significantly greater improvement in RBANS total score compared to standard treatment group (mean change +5.9 points vs. -0.2 points, p=0.041). However, there were no significant between-group differences in RBANS subdomain scores or secondary outcomes such as daily functioning, mood, neuropsychiatric symptoms, or global clinical status.

Conclusion: In this randomized controlled trial, a karaoke-based DTx appeared feasible and effective in enhancing global cognition in MCI. The findings support its potential as a complementary intervention for cognitive improvement in MCI patients.

Objective: The study aimed to investigate whether RSPO2 gene polymorphisms are associated with schizophrenia susceptibility, focusing on five specific single nucleotide polymorphisms (SNPs). Additionally, the study evaluated the expression of Rspo2 in a schizophrenic-like mouse model and examined its relationship with clinical symptoms.

Methods: The study included 159 schizophrenia patients and 448 controls. Clinical symptoms were assessed using the Operational Criteria Checklist for Psychotic Illness. Genotyping of five RSPO2 SNPs was performed to identify potential genetic associations with schizophrenia. Rspo2 mRNA expression levels were measured in the brains of MK-801-induced schizophrenic-like mice. Functional analysis of the rs374810 SNP was conducted using a luciferase assay to evaluate its effect on gene activity. Statistical analyses were used to compare genotype and allele frequencies and assess correlations with clinical outcomes.

Results: Significant associations were found between schizophrenia and two SNPs, rs374810 and rs423940. The A allele of rs374810 and the T allele of rs423940 were linked to an increased risk of schizophrenia (p=0.0049 and p=0.0044, respectively). Functional analysis revealed that the A allele of rs374810 significantly increased luciferase activity compared to the G allele, indicating a potential functional role. RSPO2 expression was also altered in the schizophrenic-like mouse model, suggesting its involvement in schizophrenia pathogenesis.

Conclusion: The findings indicate that RSPO2 gene polymorphisms, particularly rs374810 and rs423940, may contribute to schizophrenia susceptibility. Therefore, RSPO2 expression may be associated with the susceptibility to schizophrenia in the Korean population.

Objective: This study aimed to assess the prevalence of comorbid of smartphone addiction and depressive symptoms and identify their common and distinct risk factors among college students.

Methods: A total of 8,347 Chinese college students participated in the study by completing questionnaires that assessed individual, family, school, and peer factors, as well as smartphone addiction and depressive symptoms. Multivariate logistic regression was conducted to explore the risk of smartphone addiction only, depressive symptoms only, and their comorbidity.

Results: The prevalence rates of smartphone addiction only, depressive symptoms only, and their comorbidity were 30.5%, 8.9%, and 25.3%, respectively. Higher frequency of mobile phone use in lessons and lower level of school belonging were associated with the increased risk of all three disease outcomes. There was a dose-response relationship between the number of risk exposures and the three disease outcomes.

Conclusion: The more risk factors of college students were exposed to, the more likely they were to develop smartphone addiction only, depressive symptoms only, and their comorbidity. Targeted preventive measures and solutions should be implemented to reduce the occurrence of smartphone addiction and depressive symptoms.

Objective: Suicidal behavior among adolescents has become increasingly prevalent in recent years, positioning suicide as one of the leading causes of death in this age group worldwide. Despite this growing public health concern, country-specific data remain limited, particularly in Türkiye. This study aimed to examine the sociodemographic and clinical characteristics of adolescents referred to psychiatric services following a suicide attempt in Türkiye.

Methods: We enrolled adolescents (12-18 years) who presented to the Pediatric Emergency Department after a suicide attempt and were subsequently referred to our clinic. Participants completed a Sociodemographic Data Form and underwent the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version interview to assess lifetime psychiatric diagnoses.

Results: Among the 60 participants, 86.7% were female and 13.3% were male. The mean age was 184.7±13.6 months (range: 144-211 months). Two-thirds (66.7%) met criteria for at least one psychiatric disorder; major depressive disorder was most prevalent (41.7%). The predominant method of attempt was medication ingestion, and family conflict was identified as the leading precipitant (56.7%). A history of prior suicide attempts was reported by 40%, and 33.3% had a family history of suicide. Notably, 70% had engaged in non-suicidal self-harming behavior (SHB) before their attempt.

Conclusion: Suicide attempts peak during middle adolescence, and female adolescents are at higher risk. Clinicians should monitor warning signs such as a prior history of SHB. Given the high prevalence of psychiatric disorders in both these adolescents and their parents, early identification and intervention are essential to prevention.

Objective: We aimed to investigate whether the risks of suicide and non-suicide death vary based on the presence of psychiatric disorders.

Methods: Patients diagnosed with psychiatric disorders in South Korea between January 1, 2017, and December 31, 2017, were included and referred to as the psychiatric disorder (PY) group. A comparison group, the non-PY group, included individuals who had never been diagnosed with psychiatric disorders, selected using a 1:1 stratified random sampling technique based on age and sex. The patients were followed up for death by suicide (primary endpoint) from January 1, 2018 to December 31, 2022. All other causes of death were categorized as non-suicidal deaths.

Results: After 1:1 propensity score (PS) matching, 761,384 adult participants (380,692 in each group) were finally included. Of these, 0.2% (830/380,692) of individuals in the PY group died by suicide, compared with <0.01% (13/380,692) in the non-PY group. The PY group had a 64.43-fold higher risk of suicide death (hazard ratio [HR]: 64.43, 95% confidence interval [CI]: 37.25-111.43, p<0.001) compared to the non-PY group. Additionally, 8.6% (32,746/380,692) of the PY group died from non-suicidal causes, while 7.1% (27,043/380,692) of the non-PY group died from non-suicidal causes. PY group had a 1.22-fold higher risk of non-suicidal death (HR: 1.22, 95% CI: 1.20-1.24, p<0.001) compared to the non-PY group.

Conclusion: Psychiatric disorders were associated with a significantly elevated suicidal risk in South Korea, which was substantially greater than the risk of non-suicidal deaths.

Objective: Employment status is a key indicator of socioeconomic status, and unstable employment conditions can cause various social problems. However, research in Asian populations on the association between employment status and mental health, particularly suicidal ideation, remains relatively limited. This study investigated the association between employment status and suicidal ideation in general population in South Korea.

Methods: Using data from the 2015, 2017, and 2019 Korea National Health and Nutrition Examination Survey (KNHANES), 6,509 participants aged ≥20 years were analyzed. Suicidal ideation was characterized by individuals considering suicide seriously within the past year. Covariates were adjusted to account for factors such as sociodemographic, health behavior, and mental health factors. Multivariable logistic regression was performed, along with stratified analyses by subgroups of sociodemographic, health behavior, and mental health factors to assess effect modification.

Results: In our KNHANES data analysis, unemployed individuals had 1.85 times higher odds of reporting suicidal ideation compared to employed individuals (adjusted odds ratio, 1.85; 95% confidence interval, 1.41-2.44; p<0.001). In subgroup analysis, all covariates- except women and low body mass index-showed effect modification on the association between employment status and suicidal ideation.

Conclusion: This study demonstrated that unemployed status was significantly associated with increased suicidal ideation. These findings suggest that further research and policy attention are warranted to better understand and address the mental health needs of unemployed individuals.

Objective: Attention-deficit/hyperactivity disorder (ADHD) frequently persists into adulthood and leads to significant impairment across multiple domains. Cognitive behavioral therapy (CBT) has been proposed as a promising adjunctive treatment. We aimed to evaluate the effectiveness of a structured group-based CBT program for adults with ADHD and examine whether cognitive ability and treatment adherence moderate treatment response.

Methods: A retrospective analysis was conducted on 24 adults who completed a 10-session group CBT program. ADHD symptoms were assessed pre and postintervention using the Adult ADHD Self-Report Scale (ASRS) and Korean Adult ADHD Rating Scale (K-AARS). Subgroup analyses were performed based on full-scale intelligence quotient (FSIQ), session attendance, and presence of comorbid depression.

Results: A significant improvement in symptoms was observed across most ASRS and K-AARS domains. Functional impairment, as measured using the K-AARS impairment subscale, also improved significantly. Participants with an average FSIQ (90-109) showed the most consistent improvements, whereas those with below-average and high FSIQ also benefited to varying degrees. Higher attendance rates were associated with greater reduction in symptoms. The presence of comorbid depression did not significantly affect the treatment outcomes.

Conclusion: Group-based CBT is an effective adjunct intervention for managing adult ADHD symptoms. Notably, the intervention led to significant improvements in functional impairment, highlighting its potential to enhance daily functioning in adults with ADHD. Tailoring interventions based on cognitive profiles and emphasizing treatment adherence may enhance therapeutic outcomes. Future studies should employ larger sample sizes, randomized controlled designs, and longitudinal follow-up assessments to validate and extend these findings.

This case report discusses a 62-year-old male with treatment-resistant bipolar II depression and hypertension. After poor responses to multiple treatments, an add-on esketamine nasal spray (ESK-NS) was introduced in October 2022. Improvement was seen, and the patient's depressive episode was nearly remitted during the maintenance phase. However, recurrence was noted when ESK-NS frequency was reduced to once every 2 months, indicating that the dosing frequency should be adjusted cautiously. The patient experienced common side effects, including dissociation, dizziness, and transient hypertension. Nifedipine was offered when his systolic blood pressure exceeded 160 mm Hg, accompanied by headache or dizziness. Blood pressure monitoring was essential throughout ESK-NS treatment. This report highlights esketamine's potential for bipolar depression treatment and calls for further studies on its cardiovascular effects and proper management.

Objective: Major depressive disorder (MDD) is a prevalent and debilitating psychiatric condition. This study developed a group-based acceptance and commitment therapy (GACT) program for MDD and conducted a randomized controlled trial to evaluate its effectiveness. The study aims to assess the effects of GACT and identify factors influencing depression recovery in patients with MDD in Korea.

Methods: Individuals diagnosed with MDD, aged 18-40 years, were recruited. Fifty-nine participants were randomly assigned to either the GACT or waitlist control (WLC) group, with 50 participants (27 in GACT and 23 in WLC) successfully completing the program.

Results: The GACT group demonstrated significant improvements in depression symptoms (Center for Epidemiological Studies-Depression Scale, CES-D), rumination (Ruminative Response Scale-Revised, RRS-R), experiential avoidance (Acceptance and Action Questionnaire-II, AAQ-II), and cognitive fusion (Cognitive Fusion Questionnaire, CFQ) compared to the WLC group (all ps<0.05). Correlation and multivariate regression analyses indicated that improvements in CES-D scores were associated with changes in AAQ-II scores.

Conclusion: Our findings suggest that the 8-week GACT program has positive effects on depressive symptoms and ACT-related psychological processes in patients with MDD. This study highlights GACT as a promising group-based intervention for depression, potentially reducing the burden of individual psychological treatments.

Objective: This study aimed to evaluate the neurophysiological and cognitive effects of a tablet-based cognitive training program in cognitively unimpaired (CU) older adults, in order to explore its potential as an accessible intervention for promoting cognitive health in aging populations.

Methods: In a single-center, rater-blind randomized controlled trial, 40 CU older adults were assigned to either a 10-week tablet-based cognitive training intervention or a passive control group. Resting-state quantitative electroencephalography was conducted to assess spectral power and functional connectivity (FC) across cortical regions. Cognitive outcomes were measured using seven tests from the Cambridge Neuropsychological Test Automated Battery, covering memory, attention, and executive function domains.

Results: Compared to the control group, participants in the intervention group showed significant increases in absolute power in beta1-3, theta, and gamma frequency bands, particularly in frontal and central regions. FC analysis revealed enhanced coherence in fronto-temporal and occipital regions following the intervention. Cognitive assessment demonstrated significant improvements in memory tasks, including delayed matching to sample, paired associates learning, and pattern recognition memory, in the intervention group. No significant changes were observed in attention or executive function domains.

Conclusion: Tablet-based cognitive training was associated with measurable neurophysiological changes and selective improvements in memory performance among CU older adults. These findings support the potential of digital cognitive training as a non-pharmacological intervention to promote cognitive resilience and neural efficiency in aging. Further large-scale and long-term studies are warranted to confirm the durability and underlying mechanisms of these effects.