Psychiatry Investigation最新文献

Objective: Attention-deficit/hyperactivity disorder (ADHD) includes three subtypes: inattentive type (ADHD-I), hyperactive/impulsive type (ADHD-HI), and combined type (ADHD-C). Diagnosis mainly relies on subjective behavioral rating scales, lacking objective biomarkers. Electroencephalography (EEG) and serum neurotrophic factors-brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), glial cell line-derived neurotrophic factor (GDNF), and neurotrophin-3 (NTF3)-may aid subtype differentiation. This study evaluates their combined diagnostic value in children with ADHD.

Methods: A retrospective cohort of 322 children aged 6-12 years diagnosed with ADHD based on DSM-5 criteria was analyzed. EEG recordings were processed using Fast Fourier Transform to extract frequency band powers and P300 wave features. Serum levels of BDNF, NGF, GDNF, and NTF3 were measured via ELISA. Analysis of variance (ANOVA), multivariate regression, and ROC curve analyses were performed to assess diagnostic performance.

Results: ADHD-I patients exhibited elevated frontal θ power, higher θ/β ratios, prolonged P300 latency, and reduced P300 amplitude. ADHD-HI patients demonstrated increased β power in parietal regions and elevated NGF and NTF3 levels. Multivariate analysis identified θ power, θ/β ratio, NGF, NTF3, and P300 amplitude area as independent predictors for subtype differentiation. Combined EEG and serum markers yielded an area under the curve (AUC) (0.90) in distinguishing ADHD-I from ADHD-HI.

Conclusion: The integration of EEG features and neurotrophic factor profiles offers high diagnostic accuracy in differentiating ADHDI from ADHD-HI and moderate accuracy for the other subtype comparisons. These findings support the development of objective biomarker- based diagnostic tools for precision psychiatry in ADHD.

Objective: This study examined the moderating effect of dating violence awareness on the relationship between clinginess and dating violence.

Methods: A survey was conducted online (Google Forms) and only those with dating experience (more than 3 months) were included in the study. A total of 450 participants were included in the final analysis (mean age=27.96 years, SD=5.04). The moderating effect was verified using the PROCESS macro for SPSS 2.16.

Results: The results showed that clinginess positively impacted dating violence. Second, past fixation, lack of nowness, and desire obsession were among the subfactors of clinginess that had a positive impact on dating violence. Third, dating violence awareness moderated the relationship between clinginess and dating violence.

Conclusion: This study provides a theoretical basis for preventing dating violence in early adulthood and providing intervention.

Objective: Stress and coping strategies can influence the onset and recurrence of mood episodes. Assessment and classification of stress-coping behaviors might be necessary for intervention to correct maladaptive coping strategies. This study aimed to explore clinical types of stress-coping behaviors in patients with mood disorders using cluster analysis, and compare clinical characteristics among clusters.

Methods: This study included 252 patients with mood disorders. Types of stress-coping behaviors were classified by cluster analysis using the scores of the Behavioral Checklist for Coping with Stress. Clinical characteristics, measured by Clinical Global Impression Severity, Mood Disorder Questionnaire, and Bipolar Spectrum Diagnostic Scale, Beck Depression Inventory-II, State-Trait Anxiety Inventory, were compared among clusters.

Results: Stress-coping behaviors were identified into four clusters named Balanced, Withdrawn, Impulsive, and Active Clusters. The Balanced Cluster used personal and social activities predominantly and was coping adaptively and less depressed. The Withdrawn Cluster showed significantly fewer coping behaviors and was more depressed. The Impulsive Cluster used pleasure-seeking behaviors predominantly and personal activities minimally. They showed more bipolarity and were depressed. The Active Cluster used the most numerous coping behaviors. They showed more bipolarity and were not depressed.

Conclusion: This study showed four types of stress-coping behaviors, such as Balanced, Withdrawn, Impulsive, and Active types, reflecting different clinical characteristics. Future research needs to be conducted to determine whether each type of stress-coping behavior is related to clinical prognosis in prospective studies and whether modification of coping behavior can improve prognosis.

Objective: This study examined the modifying effects of functional levels on the associations of the low frequency (LF) and high frequency (HF) components of heart rate variability (HRV) with post-traumatic stress disorder (PTSD) development.

Methods: Participants with physical injuries were recruited from a trauma center and followed for 2 years. Baseline assessments included LF, HF, and functional levels measured by the Social and Occupational Functioning Scale. Socio-demographic and clinical covariates were collected. PTSD diagnoses were made at 3, 6, 12, and 24 months post-injury using the Clinician-Administered PTSD Scale for DSM-5. Logistic regression analyses were performed to assess associations. Among 538 participants, 58 (10.8%) developed PTSD during the study period.

Results: A significant modifying effect was found: lower LF/HF were significantly associated with PTSD in patients with lower functioning levels, but not in those with higher functioning levels, with significant interaction terms.

Conclusion: The study observed functioning level-dependent associations between LF/HF and PTSD development, highlighting the buffering effects of higher functioning levels. These findings underscore the importance of considering functional status in PTSD risk assessments and the potential benefits of interventions aimed at enhancing social and occupational functioning to mitigate PTSD risk.

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.