Psychiatry Investigation最新文献

Objective: Following the 1997 IMF economic crisis, Korea experienced a rapid increase in the suicide rate and has maintained the highest rate among OECD countries. This narrative review examines the development of suicide prevention policies, service delivery systems, and laws aimed at reducing suicide rates and their impact on national suicide prevention efforts in Korea.

Methods: A comprehensive data review of clinical research and reports on suicide prevention was conducted. Key findings were summarized, and outcomes related to suicide prevention programs were analyzed.

Results: This paper presents data including mortality statistics, statistics on suicide attempts, psychological autopsies, and comprehensive investigations of suicide deaths. It also reviews the trends and changes in the National Suicide Prevention Action Plans established since 2004 and explains the Suicide Prevention Act enacted in 2011. Additionally, the authors discuss key delivery systems for community suicide prevention services and programs for the early detection and intervention of depression.

Conclusion: The analysis revealed that suicide prevention research, policies, and delivery systems in Korea are highly systematic. However, challenges remain in the effectiveness of some suicide prevention efforts. This paper addresses these challenges and suggests ways to improve national suicide prevention efforts in preparation for the 6th Action Plan.

Objective: Exploring the relationship between alexithymia, cognitive function and the pain and emotional symptoms in adolescent patients with migraines.

Methods: The Toronto Alexithymia Scale (TAS)-20 was used to evaluate adolescent patients with migraines. A total score of TAS-20 ≤51 scores was defined as no alexithymia, and the patients were divided into alexithymia group and no alexithymia group. Both groups of patients were evaluated using a visual analog scale (VAS), Hamilton Anxiety Scale, Hamilton Depression Scale, and Chinese version of the Neuropsychological State Test (Repeatable Battery for the Assessment of Neuropsychological Status [RBANS]). Emotional symptoms, cognitive function, pain levels, serum levels of serotonin (5-HT), matrix metalloproteinase (MMP)-9, and lysophosphatidic acid were compared in the two groups. Structural equation modeling (SEM) was constructed.

Results: There were significant differences in the severity of emotional symptoms, pain, anxiety, and depression, as well as cognitive function between the two groups (p<0.05). There was a significant difference in serum 5-HT and MMP-9 levels between the two groups (p<0.05). Alexithymia was negatively correlated with immediate memory, speech function, delayed memory, and RBANS total score. Cognitive function may have a partial mediating role in pain, anxiety, and depression in the constructed SEM.

Conclusion: Alexithymia was shown to have a close relationship with cognitive function, and the pain, anxiety, and depression among adolescent patients with migraines. Alexithymia might affect the pain, anxiety, and depression in adolescent patients with migraines through partial mediation of cognitive function as shown in the constructed SEM.

Objective: Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder for which there is currently no effective treatment, and no reliable diagnostic biomarkers are available for ASD.

Methods: The present study was designed to compare the gene expression profiles in children with ASD and typically developing children and validate differentially expressed genes (DEGs) to assist in the search for the pathophysiological markers of ASD.

Results: The results demonstrated the identification of 35 common DEGs with down-regulated expression and 21 with up-regulated expression. Gene ontology and Kyoto Encyclopedia of Genes and Genomes analyses demonstrated that these DEGs were predominantly involved in signaling and immunity pathways. Our findings revealed that hydroxycarboxylic acid receptor 3 (HCAR3) and tumor necrosis factor ligand superfamily member 15 (TNFSF15) were associated with ASD-related symbols. Following validation by external and internal cohorts, HCAR3 may be identified as a risk gene for ASD.

Conclusion: Collectively, our findings indicate that some signaling-related and immune-related genes are expressed abnormally in children with ASD, and suggest that HCAR3 plays a critical role in the ASD phenotype. These findings may offer promising avenues for developing effective diagnostic biomarkers for ASD.

Objective: This study investigates the relationship between depression, autonomic dysfunction, inhibitory control (IC), and reaction time by analyzing heart rate variability (HRV) during a cognitive task.

Methods: A total of 29 healthy males and 25 males diagnosed with depression (aged 20-35 years) participated. HRV data were recorded during the Conners Continuous Performance Test-II (CCPT-II) in each group. HRV parameters, including mean RR intervals, standard deviation of normal-to-normal heartbeats (SDNN), low-frequency power with logarithm (lnLF), and high-frequency power with logarithm (lnHF), were analyzed and correlated with IC (d') and reaction time.

Results: The depression group exhibited significantly lower lnHF values compared to the healthy group. SDNN and lnLF decreased in both groups during CCPT-II. In the healthy group, d' correlated significantly with SDNN, lnLF, and lnHF at t14 and across the test duration. However, in the depression group, only RR intervals correlated with d'. A significant correlation between reaction time and HRV was noted at t14 in the healthy group, suggesting autonomic nervous system (ANS) involvement in cognitive performance.

Conclusion: Reaction time in healthy individuals correlated with ANS function during later stages of CCPT-II, whereas depression disrupted this association. The lower d' in the depression group was not due to a speed-accuracy trade-off but rather a more pronounced neural network impairment. These findings suggest that depression impairs both IC and autonomic regulation.

Objective: This study aimed to classify the level of resilience among outpatients and investigate the relationship of resilience with depression, state anxiety, and psychological factors.

Methods: A total of 1,498 outpatients were recruited from a university hospital in Korea. The latent profile analysis of the resilience factor was identified using the R-based Jamovi 2.3.24 software. One-way analysis of variance was used to compare the differences between depression, state anxiety, and psychological factors; Scheffe's test was used to conduct multiple comparisons.

Results: Three latent profiles were identified, including the high level of resilience (Class 1, 19.7%), the moderate level of resilience (Class 2, 47.9%), and the low level of resilience (Class 3, 32.4%). Depression and state anxiety were higher in Class 3 than Class 1 and 2. In analyzing Class 1, individuals with depressive and anxiety symptoms scored higher on anger rumination compared with those without symptoms, but there were no differences in cognitive emotion regulation. Childhood emotional neglect was higher for individuals with depressive symptoms compared to those without symptoms in Class 1.

Conclusion: This study provides an in-depth understanding of resilience and insights into the association between resilience, depression, anxiety, and psychological factors. It is necessary to provide sufficient support and interventions to regulate anger rumination and emotional factors among outpatients in Class 1 with depression and state anxiety symptoms.

Objective: To investigate the association between adverse childhood experiences (ACEs) and depression in old age, and further examine the moderating role of ACEs on the relationship between later-life disability and depression.

Methods: This study utilizes data from the 2018 China Health and Retirement Longitudinal Study and the 2014 life course survey, employing the binary logistic regression to explore the relationship between ACEs and depression in old age, and applying a multiplicative interaction analysis method to explore the moderating effect of ACEs on the relationship between later-life disability and depression.

Results: The results show a positive association between ACEs and the likelihood of depression in old age (moderate relationship with parents: odds ratio [OR]=1.140, 95% confidence interval [CI] [1.006-1.293]; poor relationship with parents: OR=1.438, 95% CI [1.229- 1.684]; experiencing family stress events: OR=1.214, 95% CI [1.077-1.369]; living in an unsafe community: OR=1.284, 95% CI [1.049- 1.571]; sometimes or often being bullied by peers: OR=1.415, 95% CI [1.188-1.685]). Additionally, the association between later-life disability and depression is significantly weaker among older adults who reported sometimes or often being bullied by peers during childhood, compared to those without such experiences (OR=0.410, 95% CI [0.204-0.826]).

Conclusion: ACEs are positively associated with the likelihood of depression in old age, yet they may also serve a protective role in mental health during later-life severe adversity, such as disability. This protective effect may be attributed to post-traumatic psychological resilience, highlighting the importance of targeted interventions to enhance resilience in individuals exposed to trauma, as well as the integration of trauma-informed care into mental health services for older adults.

Objective: Adverse childhood experiences (ACEs) represent a major public health concern, exerting profound and lasting effects on physical and mental health. However, the burden and specific impacts of ACEs among university students-a population undergoing significant developmental transitions-remain limited. This study aims to address this gap by exploring the prevalence of ACEs and their associations with mental health outcomes and life satisfaction among first-year university students in Vietnam.

Methods: A cross-sectional study was conducted among 1,391 first-year college students in six universities/faculties in Vietnam from August 2021 to August 2022. A questionnaire comprising four components was utilized to collect information from participants. Multivariate linear regression models were employed to identify factors associated with the levels of depression and life satisfaction among participants.

Results: Among 1,391 participants, 54.4% reported experiencing depressive symptoms. Regarding the number of ACEs, 50% of the participants reported that they experienced at least one ACE, and there were 34.8% encountering multiple ACEs (defined as two or more). The study also highlighted the statistical differences in the number of ACEs between depressed individuals and those who did not (p<0.001). The findings revealed a strong correlation between ACEs and the increase in depression levels and poor life satisfaction.

Conclusion: This study highlighted the relatively high prevalence of ACEs and their negative impacts on mental health status and life satisfaction. The results suggest that important strategies such as screening for ACEs and mental health conditions, implementation of community-based programs, and promotion of resilience-focused interventions can play a critical role in mitigating the impact of ACEs, ultimately contributing to healthier individuals and societies.

Objective: The relationship between childhood trauma (CT) and the outcomes of selective serotonin reuptake inhibitor (SSRI) treatment for major depressive disorder (MDD) remains uncertain. The objective of this study is to investigate the overall association between CT and treatment outcomes in patients with MDD and the associations of different CT subtypes with the treatment outcomes of various MDD symptom dimensions.

Methods: A post hoc analysis of 285 adult patients with MDD from a multicenter, prospective study in China. Patients who completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF) and 8-week SSRI treatment were included. Depressive symptoms were evaluated using the 17-item Hamilton Rating Scale for Depression (HRSD-17) at baseline and at 2, 4, and 8 weeks. The primary outcome was defined as the percentage reduction in the total HRSD-17 score at the 8th week. The secondary outcomes included the percentage reduction in anhedonia and insomnia, derived from the HRSD-17. Linear regression analyses were conducted to evaluate the associations between the CTQ-SF score and treatment outcomes.

Results: Emotional neglect (EN) was associated with lower percentage reductions in HRSD-17 scores (β=-3.035, p=0.019), anhedonia (β=-4.227, p=0.044) and insomnia (β=-7.054, p=0.045) at 8 weeks. The total CTQ-SF score and other subscale scores were not significantly associated with treatment outcomes.

Conclusion: EN was associated with poorer SSRI treatment outcomes in MDD patients, with less improvement in overall depressive symptoms and anhedonia and insomnia in particular. EN should be prioritized in MDD treatment.

Objective: The Lebanese people have endured through several disasters, such as the Beirut explosion, coronavirus pandemic, and cholera outbreak. However, volunteers who have tried to overcome such national disasters develop emotional stress after witnessing people's death. This study was conducted to explore whether volunteers' depression or anxiety mediates the relationship between grief response and post-traumatic stress disorder (PTSD) symptoms.

Methods: We conducted an anonymous online survey study and collected responses from 270 volunteers in Lebanon from March 20-26, 2023. Demographic information and responses to the questionnaires, which included the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5), Public Service Motivation scale (PSM scale), Connor-Davidson Resilience Scale-2, and Prolonged Grief Disorder (PG-13) were collected. Variables were compared between volunteers who did and did not witness people's death. Furthermore, we explored the relationships among variables in volunteers who witnessed people's death (n=72).

Results: Among 270 participants, 72 (26.67%) witnessed people's death. The regression model demonstrated that scores for PG-13 (β= 0.31, p<0.001), PHQ-9 (β=0.21, p=0.011), and GAD-7 (β=0.44, p<0.001) were predictors of the PCL-5 score. Mediation analysis showed that grief reaction directly influenced PTSD symptoms (Z=6.19, p<0.001), whereas depression (Z=1.99, p=0.047) and anxiety (Z=2.79, p=0.005) individually mediated the relationship between grief reaction and PTSD symptoms.

Conclusion: Our study helps understand the mediating effects of volunteers' depression or anxiety on the relationship between grief reactions and PTSD symptoms.