Psychiatry Investigation最新文献

Objective: Patients with panic disorder (PD) are approximately four times more likely than the general population to exhibit suicidal ideation (SI) and suicide attempts. Although prolonged duration of untreated illness (DUI) is a known risk factor for adverse outcomes in mood disorders, its impact on suicidality among patients with PD has not been well established. This study investigated whether prolonged DUI is associated with heightened SI among patients with PD, considering sociodemographic and clinical factors.

Methods: A total of 804 patients with PD were recruited. DUI was defined as the time between symptom onset and the initiation of psychiatric treatment. Clinical assessments included the Scale for Suicide Ideation (SSI), Beck Depression Inventory-II (BDI-II), and Panic Disorder Severity Scale. Sociodemographic and clinical predictors of SI were examined using independent t-tests, Pearson's correlations, and multiple regression analysis.

Results: In patients with PD, the mean DUI was 41.56 months. Longer DUI was positively correlated with higher SSI total scores, along with greater depression severity. Gender women, unmarried status, and elevated BDI-II scores were significantly predicted higher SSI total scores. In the multiple regression model, prolonged DUI remained an independent predictor of SSI (B=0.116, p=0.012) after adjusting for other variables.

Conclusion: These findings indicate that delayed treatment contributes to increased suicidality in PD, beyond demographic and depressive risk factors. Therefore, early detection and timely intervention using treatment strategies that enhance awareness, improve the accessibility of psychiatric services, and provide social support may reduce DUI and mitigate suicide risk among patients with PD.

Objective: This study aimed to develop a machine learning-based classification model to differentiate bipolar disorder from major depressive disorder using self-report scales, including the Mood Disorder Questionnaire (MDQ), Bipolar Spectrum Diagnostic Scale (BSDS), and Anger Coping Scale (ACS).

Methods: A total of 122 bipolar and 67 depressive patients participated. Recursive feature elimination with 1,000 iterations was used to identify the most informative features. Machine learning classifiers assessed combinations of MDQ, BSDS, and ACS items for classification performance.

Results: The AUC values for MDQ and BSDS were 0.8212 and 0.7934, respectively. Combining MDQ and BSDS increased the AUC to 0.8477, which improved further to 0.8548 when ACS was included. For MDQ, the best performance was achieved when all 13 items were included. In contrast, the combined model of MDQ, BSDS, and ACS showed optimal performance when BSDS items 18 (conflicts with colleagues or police), 19 (alcohol or substance use), and ACS item 15 (beating others) were excluded.

Conclusion: Integrating anger coping styles with mood symptoms enhanced diagnostic accuracy, particularly when items related to undesirable behaviors were excluded. This machine learning approach shows potential for effectively evaluating bipolarity and underscores the importance of refining self-report scales to optimize diagnostic tools. Future research should incorporate clinical and objective data to enhance classification models.

Objective: Internet gaming disorder (IGD) is a growing problem, particularly among adolescents. Although cocaine- and amphetamine- regulated transcript (CART) has been explored as a potential biomarker for addictive disorders, its relationship with IGD remains poorly understood. This study investigated the differences in serum CART levels between adolescents with IGD and healthy controls (HCs) in order to find potential biomarkers as a therapeutic target in IGD. Additionally, we investigated correlations of serum CART levels with personality traits within the IGD group.

Methods: A total of 114 adolescents participated in this study (43 in the IGD group and 71 in the HC group). Blood samples (10 mL) were collected and serum CART concentrations were determined using an enzyme-linked immunosorbent assay. Participants also completed the Junior Temperament and Character Inventory.

Results: Serum CART levels in the IGD group were significantly lower than those in the HC group (p<0.05). IGD participants had higher novelty-seeking and harm-avoidance traits, accompanied by reduced persistence, self-directedness, and cooperativeness. Notably, a significant correlation emerged between serum CART levels and cooperativeness within the IGD group. Lower cooperativeness trait scores could indicate reduced social interaction.

Conclusion: The present findings suggest serum CART levels might serve as a neurobiological marker for cooperativeness function in adolescents with IGD.

Objective: Increases in white matter hyperintensities (WMH) observed on brain MRI are associated with the onset of Alzheimer's disease (AD) and cognitive decline. Recent hypotheses suggest that the impact of WMH on cognition may differ by their distance from the ventricular surface. This study aimed to investigate the effects of WMH volume and location, classified by distance from the ventricular surface, on cognitive function in individuals with AD.

Methods: A total of 112 normal cognition (NC) individuals and 171 patients with AD underwent clinical evaluation, volumetric MRI, and neuropsychological testing using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease. WMH volume was categorized as juxtaventricular (JVWMH, <3 mm from ventricle), periventricular (PVWMH, 3-13 mm), and deep (DWMH, >13 mm).

Results: The mean WMH volume was significantly higher in AD group (20.7±18.2 mL) than in the NC group (6.8±8.1 mL, p<0.001). A tenfold increase in WMH volume led to a 5.967-fold increased risk of AD (95% confidence interval [CI]=1.550-22.986). A similar risk association was observed for PVWMH (OR=4.021, 95% CI=1.592-10.156), and DWMH showed a significant risk association (OR= 2.873, 95% CI=1.227-6.731). Total WMH, JVWMH, and PVWMH were associated with poorer performance in verbal fluency and memory tasks, while DWMH showed no significant cognitive association.

Conclusion: WMH volume and location independently contribute to AD risk and cognitive decline, with PVWMH and JVWMH particularly affecting executive and memory functions, regardless of hippocampal atrophy.

Objective: This study investigated the clinical features and personality traits of pediatric and adult patients with avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa-restricting type (RAN) in a Korean hospital cohort, and the distinct characteristics of ARFID in a non-Western sample.

Methods: This retrospective cohort study included 392 Korean outpatients with ARFID (n=68) or RAN (n=324) at an eating disorders clinic. Clinical characteristics including eating and general psychopathology, and personality traits based on the five-factor model and behavior inhibition/activation systems were assessed. The eating and general psychopathology and personality traits of pediatric and adult patients with ARFID were retrospectively investigated alongside those of pediatric and adult RAN patients.

Results: Patients with ARFID had an earlier onset age, a longer illness duration, and lower levels of eating and general psychopathology compared to those with RAN. ARFID patients also reported lower levels of neuroticism and behavioral inhibition. Pediatric ARFID patients showed less severe general psychopathology than adult patients with ARFID, while personality traits were consistent across age groups. However, pediatric RAN patients demonstrated higher dietary restraint and lower levels of general psychopathology compared to adult patients.

Conclusion: This study highlights distinct psychopathology and personality traits between ARFID and RAN. These findings emphasize the importance of age-specific interventions for ARFID. Compared to pediatric patients, adult patients with ARFID require interventions targeting psychological difficulties. The results underscore the need to improve recognition of ARFID in Korea.

Objective: The aim of the study is to explore the relationship between family accommodation, emotion regulation difficulties, and alexithymia in obsessive-compulsive disorder (OCD).

Methods: The study group consisted of 107 individuals diagnosed with OCD, while the control group included 151 healthy individuals. Sociodemographic data form, Yale-Brown Obsessive Compulsive Scale (YBOCS), Family Accommodation Scale-Patient Version (FASPV), Toronto Alexithymia Scale (TAS), and Difficulties in Emotion Regulation Scale (DERS) were used to collect data.

Results: In our study, it was found that the median DERS and TAS scores of the participants were significantly higher in the OCD group than in the control group. A moderate positive correlation was found between FAS-PV and the total score of YBOCS (p=0.002, r=0.302). Statistically significant, low to moderate, positive correlations were observed between FAS-PV and the total score of DERS (p=0.001, r=0.319). Furthermore, a statistically significant, moderate to low correlation was found between YBOCS and the total score of DERS. A positive and substantial influence on FAS-PV is provided by the YBOCS variable (B=0.571, p=0.01).

Conclusion: In conclusion, this study found that difficulty in emotion regulation and alexithymia levels were higher in individuals with OCD compared to healthy controls, and that family accommodation was related to both difficulties in emotion regulation and alexithymia. Finally, it was determined that difficulty in emotion regulation has a mediating effect in the relationship between family accommodation and alexithymia. It is suggested that longitudinal studies be conducted to further support the data presented by this study.

Objective: The nine diagnostic criteria for Internet Gaming Disorder (IGD) proposed in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) have been widely adopted, but have also faced significant criticism. This study evaluated the psychometric properties of the nine DSM-5 criteria for IGD using item response theory (IRT).

Methods: Four DSM-5-based scales, including the Game Addiction Scale, the Internet Gaming Disorder Scale Short-Form, the Ten- Item Internet Gaming Disorder Test, and the Internet Gaming Disorder Scale, were administered to 1,530 Chinese adolescents and young adults. IRT models were used to assess the psychometric properties of these criteria. The potential for differential item functioning (DIF) related to sex and between adolescents and adults was also evaluated.

Results: All nine DSM-5 criteria demonstrated very high to perfect discrimination (a >1.38), providing substantial diagnostic information (item information >0.476) for diagnosing IGD. These scales, despite variations in wording and scoring methods, exhibited strong correlations in total scores (r≥0.502, p<0.001) and high consistency (Kendall's W ≥0.656, p<0.05) concerning the fitted IRT parameters. Among the nine criteria, escape showed the lowest cross-scale discrimination, item information, and difficulty. In contrast, withdrawal showed the highest item information and discrimination, and the second highest difficulty. Additionally, there was no evidence of DIF related to sex or age (adolescents vs. adults) across nearly all scale items.

Conclusion: These findings indicate that the nine DSM-5 criteria generally possess acceptable psychometric properties for diagnosing IGD. Notably, withdrawal may represent a core symptom of IGD. Conversely, escape demonstrated inferior performance compared to the other eight criteria, indicating a potential need for further revision.

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.