Psychiatry Investigation最新文献

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.

Objective: This study aimed to examine the current status of psychiatric therapy and anti-craving prescriptions for patients with alcohol-related diseases and to evaluate the impact of these treatments on the prognosis of alcohol-related diseases for drawing implications.

Methods: Data were analyzed by combining data extracted from one hospital, data of the National Health Insurance Service, and the National Statistical Office mortality data. The rationale for utilizing an integrated data set was that a single dataset from a single hospital was insufficient for comprehending economic factors, mortality rates, and medical information.

Results: The analysis yielded two principal conclusions. Firstly, concurrent administration of psychiatric therapy and anti-craving prescriptions was demonstrated to be an effective approach in the management of alcohol-related disorders. Secondly, the economic status of patients was found to influence outcomes of psychiatric pharmacotherapy.

Conclusion: The integration of diverse alcohol-related data for management could facilitate the implementation of personalized prescriptions tailored to specific needs of each patient. This approach has the potential to reduce mortality rates and mitigate societal burdens associated with alcohol-related diseases.

Objective: This study aimed to examine the predictive validity of the revised Suicide Crisis Inventory (SCI-2) and determine its optimal cutoff score.

Methods: Data from 662 community adults participating in a one-year follow-up study were analyzed. Receiver operating characteristic analysis was conducted to examine whether the SCI-2 could predict suicide attempts and ideation with intent at the follow-up and to determine the optimal cutoff score for identifying individuals at high risk for suicide.

Results: The SCI-2 demonstrated adequate predictive validity for suicide attempts and ideation with intent at the one-year follow-up. Based on Youden's index and Runeson et al.'s criteria, a cutoff score of 102 was proposed as the threshold for high-risk groups.

Conclusion: The SCI-2, a measure of Suicide Crisis Syndrome, demonstrated predictive validity using longitudinal data. It is effective in identifying high-risk individuals in a community population. These findings highlight the SCI-2 as a valuable tool for early suicide risk detection and prevention.

Objective: Despite an increase in the depressive disorders burden during the coronavirus disease-2019 (COVID-19) pandemic, research remains insufficient. This study aims to advance the understanding of the global depressive disorders burden, focusing on the COVID-19 pandemic.

Methods: Global and regional estimates of incidence, prevalence, and disability-adjusted life years (DALYs) for depressive disorders from 1990 to 2021 were analyzed using the Global Burden of Disease Study 2021. Depressive disorders were defined as the aggregate of major depressive disorder and dysthymia. Estimates were stratified by age, sex, Socio-demographic Index (SDI), and region, and trends were assessed by annual percent change. Attributable risk factors and projections to 2050 were assessed by modeling risk factors.

Results: In 2021, depressive disorders accounted for 56,330.36 (95% uncertainty interval [UI], 39,339.99 to 76,538.17) DALYs. The age-standardized DALYs rate (ASDR) remained stable until 2019, followed by an increase during the COVID-19 pandemic (ASDR in 1990: 600.51 [95% UI, 420.94 to 818.45] per 100,000; in 2019: 593.50 [413.34 to 810.07]; in 2021: 681.14 [475.19 to 923.83]). The highest ASDRs were observed in low (837.53 [95% UI, 569.85 to 1,140.07] per 100,000) and low-middle (784.07 [542.47 to 1,059.21]) SDI regions. The burden increased rapidly among adolescents and remained higher in females than in males. The burden attributable to intimate partner violence increased during the COVID-19 pandemic. Projections suggest a modest decline in global ASDR, reaching 622.30 (95% UI, 430.96 to 847.82) per 100,000 by 2050.

Conclusion: The global burden of depressive disorders increased sharply during the COVID-19 pandemic. It is essential to address regional disparities in mental health care and promote access to tailored treatment.

Objective: Psychiatric morbidity patterns and associated outcomes among individuals with borderline intellectual functioning (BIF) remain poorly characterized. This systematic review aims to examine mental health outcomes in BIF populations compared to individuals with normal intellectual functioning and those with intellectual disability (ID).

Methods: A systematic literature search was conducted across the PubMed, Web of Science, PsycInfo, and ERIC databases from inception to January 2025 using comprehensive search terms for BIF. Studies were included in this analysis if they examined individuals with intelligence quotient (IQ) 71-84 and reported mental health outcomes. Data extraction focused on subjective well-being, psychopathology prevalence, and comparative analyses. Quality assessment utilized the Mixed Methods Appraisal Tool.

Results: Forty-five studies encompassing 93,396 individuals with BIF were included. Individuals with BIF demonstrated significantly elevated psychiatric morbidity compared with average IQ populations across multiple domains including anxiety, mood, personality, and neurodevelopmental disorders. Mental health outcomes of BIF individuals typically fell intermediate to those observed in normal IQ and mild ID populations.

Conclusion: Individuals with BIF represent a vulnerable population with substantially elevated mental health risks, yet remain inadequately differentiated from adjacent cognitive groups. The field requires specialized clinical attention, educational support, and targeted interventions to address their unique mental health challenges and improve outcomes.

Objective: Machine learning (ML) can assist in predicting suicide risk and identifying associated risk factors. Various resampling methods and algorithms must be applied to develop an ML prediction model with better performance. In this study, we developed an optimal Korean suicide prediction model by applying five ML algorithms, unsampled data, and two resampling methods.

Methods: In this study, data from the Korea National Health and Nutrition Examination Survey for 2017, 2019, and 2021 were integrated and analyzed to predict suicidal ideation in subjects aged ≥19 years. Logistic regression, random forest (RF), k-nearest neighbor, gradient boosting, and adaptive boosting were used as ML algorithms. Undersampling and oversampling are used as resampling methods to solve data imbalance problems.

Results: Among the study participants, 16,947 (95.14%) and 866 (4.86%) belonged to the control and suicidal ideation groups, respectively. Among the 15 ML models, the RF model exhibited excellent performance (sensitivity=0.781, area under the curve=0.870) in an algorithm trained with undersampled data.

Conclusion: Developing an optimized Korean suicide prediction model through additional validation based on the ML model developed in this study will help predict suicide risk factors caused by the interaction of individual, social, and environmental factors.

Objective: This study investigates the prevalent characteristics of suicidality in college students with borderline personality (BP) features. In addition, it explores the relationship between BP features and suicidality and analyzes related psychological mechanisms.

Methods: The study encompassed 6,854 college students from 12 universities in Southern China from October to December 2020. The subjects completed a general information questionnnaire, Personality Diagnostic Questionnaire 4+, ruminative responses scale, 10 items in the Connor-Davidson resilience scale, and an assessment for suicidality.

Results: Among all participants, subjects with BP features reported higher rates of suicidal ideation and suicidal attempt than those without BP features, and the differences were statistically significant (all p<0.05). Logistic regression analysis demonstrated that resilience served as a significant protective factor against both suicidal ideation and suicidal attempt in both females and males (all p<0.05). Higher borderline personality disorder (BPD) score emerged as risk factor for suicidal ideation and suicidal attempt in both females and males (all p<0.001). Symptom rumination was a risk factor for suicidal ideation in both females and males (all p<0.001). Reflection was a risk factor for suicidal attempt in both males and females (all p<0.05). Resilience and symptom rumination mediated the relationship between BPD score and suicidal ideation in both females and males. Resilience mediated the relationship between BPD score and suicidal attempt only in males.

Conclusion: College students with BP features exhibit an elevated rate of suicide-related behaviors. The relationship between BP features and suicidality is mediated by rumination and resilience.