Psychiatry Investigation最新文献

Objective: To explore the linear associations between social support, coping strategies, depression, anxiety, and cognitive function among people with type 2 diabetes mellitus (T2DM) using a path-analytic method.

Methods: This cross-sectional study enrolled 496 individuals hospitalized due to T2DM. Well-trained investigators conducted face-to-face interviews with the participants using the Social Support Rating Scale, the Chinese version of Medical Coping Modes Questionnaire, the Hospital Anxiety and Depression scale, and the Mini Mental State Examination to measure social support (including objective support, subjective support, and support utilization), coping strategies (including confrontation, avoidance, and acceptance-resignation), depression/anxiety, and cognitive function, respectively. A path analysis was used to elucidate the linear associations between social support, coping strategies, depression, anxiety, and cognitive function.

Results: In the final path model with satisfactory model fit, objective support was found to be associated with cognitive function not only directly but also indirectly through confrontation coping and depression, and acceptance-resignation coping and depression/anxiety. Further, subjective support was found to be associated with cognitive function indirectly through depression/anxiety, as well as serially through acceptance-resignation coping and depression/anxiety. Support utilization was found to be associated with cognitive function indirectly through confrontation coping and depression, as well as through acceptance-resignation coping and depression/anxiety.

Conclusion: Social support, coping strategies, depression, and anxiety were associated with cognitive function among people with T2DM, and these associations were best explained by a serial mediation model from social support, coping strategies, and depression and anxiety to cognitive function.

Objective: This study investigated to what extent a range of depressive symptoms was differentially present depending on age group in Korean population.

Methods: Data was pooled from five nationally representative surveys in which 29,418 respondents aged at least 18 years were interviewed face-to-face using the Korean version of the Composite International Diagnostic Interview. A total of 691 (2.1%) respondents were found to have had at least 1 episode of major depressive disorder (MDD) within the last 12 months. Logistic regression analysis was conducted to identify the association between age groups (18-39 years, 40-59 years, and 60 years or older) and 26 depressive symptoms among the respondents with MDD.

Results: Associations were observed between somatic symptoms-including insomnia, awakening 2 h earlier-and cognitive symptoms such as feelings of guilt, thoughts of death, and suicidal ideation with the older age group. Whereas, atypical depressive symptoms such as increased appetite, weight gain, and hypersomnia were associated with the younger age group. When adjusted for sociodemographic factors, symptoms such as depressed mood, awakening 2 h earlier, and feeling guilty in the older age group, and hypersomnia, psychomotor retardation, and worse in the morning in the younger age group still remained statistically significant. Furthermore, fatigue and decreased libido were newly associated with the younger age group.

Conclusion: The findings of this study revealed distinct patterns of symptomatology in MDD based on age groups. These differences should be considered owing to their potential relevance to treatment response and prognosis in the clinical setting.

Objective: The rate of drug craving not only in Pakistan is escalating rapidly, but also from a wide range of cultures and geographically have been impacted by the drug problem. Recently, drug cravings among young Pakistani school and college students have significantly increased, particularly illegal substances like hashish, heroin, and ecstasy.

Methods: We recruited 338 students and gathered demographic and drug-craving data through a survey. To assess the study variables, we used the parental acceptance-rejection short version, peer pressure questionnaire, and adult personality assessment scale.

Results: The prevalence rate of occasional drug craving was 44.1% (tobacco, 39.9%; heroin, 1.8%; ice, 0.6%; and others), and 55.9% have never tried them. Initially, drug craving at the first onset at the age of 14 in friend gatherings (15.7%) in stressful situations (11.2%), high-income families, particularly in joint family systems with paternal rejection, peer enforcement, and maladjustment had a higher risk than affectionate parents and conventional peers. Stepwise binary logistic regression analysis disclosed that age, socioeconomic status, father affection, hostility, rejection, negligence, peer influences, and psychosocial adjustment, mother hostility were independently associated with occasional drug cravings.

Conclusion: Findings suggested the high prevalence of occasional drug cravings in Pakistani students in the capital territory. Furthermore, the demographic and other social and clinical aspects could be linked. This study carried out theoretical significance in understanding the predictors of occasional drug craving and psychological adjustment, highlighting the peer and parent's roles and the educational institutions.

Objective: We aimed to identify the individual and interactive effects of childhood abuse and suicidal ideation on antidepressant treatment response in 12 months.

Methods: In this prospective research, 1,262 depressive patients were asked about their childhood abuse history, suicidal ideation, and other clinical characteristics and socio-demographic features at baseline, and 1,015 of them were followed during 1 year of stepwise pharmacotherapy. The individual and interactive relationships of the childhood abuse history and suicidal ideation on 12-month antidepressant non-remission were explored by logistic regression with relevant covariates.

Results: Having a childhood abuse history and higher suicidal ideation significantly predicted a non-remission state in 12 months respectively. The interaction term of childhood abuse and suicidal ideation was also significantly related to a non-remission state at 12 months. To be specific, in the low suicidal ideation group, depressive patients with a childhood abuse history were more likely to be in a non-remission state after 12 months of medication. In the high suicidal ideation group, however, childhood abuse history was not significantly associated with the non-remission state at 12 months.

Conclusion: The childhood abuse history and the level of suicidal ideation are informative factors predicting the long-term results of antidepressant treatment, especially when they are combined. Clinicians may consider antidepressants with a higher affinity for patients with childhood abuse history even if they don't have suicidal ideation. The cognitive intervention for suicidal ideation might be helpful in addition to pharmacological treatment.

Objective: Technology addiction is an increasingly important public health problem all over the world that negatively affects people's mental and physical health. In this study, we examined technology addiction and social connectedness levels of psychiatric patients who admitted to clinics in different geographical regions of Turkey.

Methods: A total of 642 people with a diagnosis of psychiatric illness who applied to psychiatry clinics in İstanbul, Elaziğ, Malatya, Yozgat, Adıyaman, and Bingöl provinces were included. Sociodemographic data form, Technology Addiction Scale (TAS), and Social Connectedness Scale (SCS) were applied to all participants.

Results: The total score of the TAS in patients diagnosed with anxiety disorder and somatoform disorder was significantly higher than the other patient groups (p<0.001). Patients diagnosed with anxiety disorder showed a significant difference from other patient groups in terms of SCS score (p<0.001). Anxiety disorder was found to be the highest in TAS total score and sub-dimensions and the lowest in SCS score, while major depressive disorder was found to be the lowest in TAS total score and sub-dimensions and the highest in SCS score. The multiple linear regression analysis showed that the total score of the TAS was predicted by the SCS score (β=-1.857, p<0.001) and the SCS score was predicted by age (β=0.046, p=0.049) and the total score of the TAS (β=-0.316, p<0.001).

Conclusion: As a result of this study, we can say that psychiatric patients have a moderate level of technology addiction, these people have high levels of social connectedness, and psychiatric patients with technology addiction have a high level of social belonging.

Objective: This study investigated the neurocognitive characteristics of patients who visited an outpatient clinic requesting diagnosis and treatment for adult attention-deficit/hyperactivity disorder (ADHD).

Methods: The patients' electronic medical records were retrospectively reviewed. Neurocognitive test results were compared using Student's t-test according to their chief complaint, depressive symptoms, childhood history, and intelligence quotient (IQ). Neurocognitive characteristics affecting subjective symptoms of ADHD were analyzed by linear regression.

Results: The study included 106 patients. They did not have significant deficits in neurocognitive tests. Patients with depressive symptoms showed more impulsive responses (hit reaction time [p=0.037] and commission error [p=0.024]) and self-reported ADHD symptoms (p=0.001). Verbal (p=0.036) and visual memory (p=0.020) were significantly deficient in patients with a childhood ADHD diagnosis. Patients with a low IQ had significant deficits in various domains. Depressive symptoms and vigilance were significantly related to subjective symptoms of ADHD (adjusted R2=0.430, β=0.457, p=0.002).

Conclusion: Our results imply that the neurocognitive function of patients with subjective ADHD symptoms was not abnormal but was affected by depressive symptoms.

Objective: We investigated the difference in sleep inertia between shift workers (SWs) and non-shift workers (NSWs) and the effects of depressive symptoms, sleepiness, insomnia, and chronotype on sleep inertia in SWs and NSWs.

Methods: Altogether, 4,561 SWs (2,142 men and 2,419 women, aged 36.99±9.84 years) and 2,093 NSWs (999 men and 1,094 women, aged 37.80±9.73 years) participated in the current study. All participants completed the Sleep Inertia Questionnaire (SIQ), Epidemiological Studies Depression Scale (CESD), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and Morningness-Eveningness Questionnaire (MEQ) through an online survey.

Results: SWs reported higher SIQ scores than NSWs after controlling for CESD, ESS, ISI, or MEQ. The CESD, ESS, ISI, and MEQ predicted SIQ in both SWs and NSWs. The effects of CESD and MEQ on SIQ were stronger in SWs and NSWs, respectively. The indirect effects of CESD and MEQ on SIQ via ESS were significantly moderated by work schedules.

Conclusion: SWs showed higher sleep inertia than NSWs. The effect of chronotypes on sleep inertia was more prominent in NSWs than in SWs. However, the effect of depressive symptoms on sleep inertia was more prominent in SWs than in NSWs. Moreover, the effect of depressive symptoms or chronotypes on sleep inertia was mediated by sleepiness, and such indirect effects were significantly different among the participants stratified by work schedules.

Objective: White matter hyperintensities (WMH) are common among the elderly. Although WMH play a key role in lowering the threshold for the clinical expression of dementia in Alzheimer's disease (AD)-related pathology, the clinical significance of their location is not fully understood. This study aimed to investigate the association between WMH and cognitive function according to the location of WMH in AD.

Methods: Subjects underwent clinical evaluations including volumetric brain magnetic resonance imaging study and neuropsychological tests using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet. WMH were calculated using automated quantification method. According to the distance from the lateral ventricular surface, WMH within 3 mm, WMH within 3-13 mm, and WMH over 13 mm were classified as juxtaventricular WMH (JVWMH), periventricular WMH (PVWMH), and deep WMH (DWMH), respectively.

Results: Total WMH volume was associated with poor performance in categorical verbal fluency test (β=-0.197, p=0.035). JVWMH volume was associated with poor performances on categorical verbal fluency test (β=-0.201, p=0.032) and forward digit span test (β= -0.250, p=0.012). PVWMH volume was associated with poor performances on categorical verbal fluency test (β=-0.185, p=0.042) and word list memory test (β=-0.165, p=0.042), whereas DWMH volume showed no association with cognitive tests. PVWMH volume were also related to Clinical Dementia Rating Scale Sum of Boxes score (β=0.180, p=0.026).

Conclusion: WMH appear to exhibit different associations with the severity of dementia and cognitive impairment according to the distance from ventricle surface in AD.

Objective: The increasing concern over adolescent suicide necessitates suicide prevention training for school teachers, as students spend a significant portion of their time at school. This study's objective is to develop a suicide prevention program tailored for teachers.

Methods: The program was developed by a multidisciplinary research team, drawing on a review of both domestic and international suicide prevention programs, related scholarly articles, and Korean psychological autopsy interviews of adolescents. This was complemented by a survey of teachers to assess the program's practicality and usability.

Results: The developed program comprises three parts, consistent with other versions: Careful Observation, Active Listening, and Risk Evaluation and Expert Referral. Careful Observation focuses on training teachers to recognize verbal, behavioral, and situational warning signs of suicidal ideation in students; Active Listening involves strategies for encouraging students to express their suicidal thoughts and techniques for being an empathetic and attentive listener; Risk Evaluation and Expert Referral provides instruction on how to assess suicide risk and assist students safely.

Conclusion: It is anticipated that this program will equip teachers with valuable knowledge and skills, contributing to a reduction in adolescents suicide rates.

Objective: Amid the coronavirus disease 2019 (COVID-19) pandemic, the pervasive threat of infection has heightened public and individual health concerns. In the context of instability, although the dysfunctional aspect of self-focus was prominent, preoccupation with viral infection was greater. This study explored the applicability of a cognitive-behavioral model of hypochondriasis to individuals infected with COVID-19 and assessed whether dysfunctional self-focus were associated with the development of preoccupation.

Methods: An anonymous online survey was conducted via a professional survey platform in December 2022. Participants' clinical characteristics and responses to rating scales were collected, including Obsession with COVID-19 Scale (OCS), Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), Stress and Anxiety to Viral Epidemic-6 items (SAVE-6), Patient Health Questionnaire-2 items (PHQ-2), and Dysfunctional Self-focus Attributes Scale (DSAS).

Results: Among the 265 participants, preoccupation with COVID-19 was predicted using CRBS (β=0.60, p<0.001), SAVE-6 (β=0.20, p=0.007), and PHQ-2 (β=0.13, p<0.001) scores. Mediation analysis revealed that viral anxiety influenced this COVID-19 preoccupation, with the relationship mediated by coronavirus reassurance-seeking behavior. Another analysis indicated that dysfunctional self-focus had a significant total effect on preoccupation with COVID-19. However, its direct impact was statistically insignificant, with the association primarily influenced by three mediating factors: viral anxiety, depression, and reassurance-seeking behavior.

Conclusion: Preoccupation with coronavirus is influenced by viral anxiety, depression, and reassurance-seeking behavior. Two mediation analyses showed that the application of the cognitive-behavioral model of hypochondriasis is feasible among COVID-19-infected cases and the association of dysfunctional self-focus with mediating factors. This finding highlights the need for personalized psychological support in managing COVID-19 cases.