Revista Brasileira de Psiquiatria最新文献

Background: Panic disorder (PD) is a common disabling condition characterized by recurrent panic attacks. Emotional and behavioral impairments are associated with functional connectivity (FC) and network abnormalities. We used the whole brain FC, modular networks, and graph-theory analysis to investigate extensive network profiles in PD.

Method: The functional MRI data from 82 PD and 97 controls were included. Intrinsic FC between each pair of 160 regions, 6 intra-networks, and 15 inter-networks were analyzed. The topological properties were explored.

Results: PD patients showed altered FCs within the right insula, between frontal cortex-posterior cingulate cortex (PCC), frontal cortex-cerebellum, and PCC-occipital cortex (corrected P values < 0.001). Lower connections within the Sensorimotor Network (SMN) and SMN-Occipital Network (OCN) were detected (P values < 0.05). Various decreased global and local network features were found in PD (P values < 0.05). In addition, significant correlations were found between PD symptoms and nodal efficiency (Ne) in the insula (r = -0.273, P = 0.016), and the FC of the intra-insula (r = -0.226, P = 0.041).

Conclusions: PD patients present with abnormal functional brain networks, especially the decreased FC and Ne within insula, suggesting that dysfunction of information integration plays an important role in PD.

Objective: To analyse the related influencing factors of adolescent major depressive disorder (MDD) with suicidal and self-injurious behaviour (SSIB).

Methods: A total of 299 adolescents with MDD who were admitted to the psychiatric department of the hospital between February 2022 and July 2023 were selected using the convenience sampling method. The participants were divided into the SSIB group (n = 110) and the non-SSIB group (n = 189) according to whether SSIB was present, and related indicators were collected and compared.

Results: The patients' ages at the time of their first SSIB ranged from 10 to 18 years old, with a mean age of 13.30 ± 1.74 years. The most commonly injured parts were the lower arm and wrist (42.13%), and the most common injury was cutting, accounting for 40.00% of the total patients. The most common type of self-injury differed by sex (X2 = 17.798, P = 0.006); for men, hitting was the most common, and for women, cutting was the most common. In 51.41% of the patients, the period between the initial thought and the actual committing of the SSIB was less than 5 minutes. The scores of the Eysenck Personality Questionnaire, the Barratt Impulsivity Scale, the Buss-Perry Aggression Questionnaire, the Symptom Checklist-90 (all P < 0.001), and the health-risk behaviour scale (67.47 ± 12.59 vs. 41.58 ± 11.36, t = 9.587, P < 0.001) were significantly increased in the SSIB group compared with the non-SSIB group. In addition, the total score of quality of life (QOL) (11.36 ± 4.32 vs. 16.43 ± 5.64, t = 5.496, P < 0.001) was decreased in the SSIB group compared with the non-SSIB group.

Conclusion: The SSIB of adolescent patients with MDD is related to various factors, including impulsiveness, aggressiveness, personality traits, QOL, and mental health level.

Introduction: Galectins (Gal) were linked with inflammatory responses in the central nervous system, may play an important role in the pathogenesis of BD.In this study,we aimed to investigate whether serum Gal-1 and Gal-3 levels are related to BD.

Methods: 36 patients diagnosed with BD were included.C-Reactive Protein(CRP),Gal-1,Gal-3 blood levels were evaluated on the first day of hospitalization and the third week of treatment and compared with 41 healthy controls.The severity of the illness was evaluated with the Young Mania Rating Scale (YMRS).

Results: CRP levels of BD patients at hospitalization were significantly higher than the third week of treatment and healthy controls.Gal-1 levels on the first day of hospitalization and the third week of treatment were found higher than the healthy controls.There was no significant difference in Gal-3 levels of the patients on the day of hospitalization compared to healthy controls;at the end of the 3rd week of treatment,Gal-3 was statistically significantly higher than the first day of hospitalization.

Conclusion: Our study is valuable in that it is the first study to show the change in Gal levels after treatment and to evaluate the role of Gal in BD.Gal-1 may play roles in the pathophysiology of BD.Gal-3 may be a biomarker candidate for the evaluation of the treatment response.

Few pandemic studies explored positive aspects of mental health and employed an intersectional perspective, which considers the concomitant action of different risk conditions. Our intersectional investigation aimed to identify possible mental illness and well-being differences between groups identified as psychologically vulnerable in the pandemic by the WHO (immigrants, minorities, and people with psychiatric diagnoses) and people without pre-existing risk factors while controlling for sociodemographic variables. A cross-sectional survey involved 1,134 participants (76.1% women) aged 18 to 76. We utilized the Depression, Anxiety, and Stress Scales (DASS-21) for mental disorder assessment and the Life Satisfaction and Positive and Negative Affects Scales for well-being evaluation. Since a variable-centered approach, multivariate analysis revealed significant differences between the groups in the variables of mental health, depression [F(2.1131)=72.7, p<.001], anxiety [F(2.1131)=78.0, p<.001], stress [F(2.11 1)=85.9, p<.001], and subjective well-being [F(2.1131)=53.6, p<.001]. The groups also differed when we employed a person-centered approach to analyze the variables jointly using Latent Profile Analysis. We identified six mental profiles composed of different levels of depression, anxiety, stress, and well-being. Risk and intersectional groups were more likely to be characterized by Generalized Suffering [ORrisk=0.85, ORintersec=0.93] and Profound Anguish [ORrisk&intersec=0.97] profiles. Control of demographic variables indicated that mental health disparities were partially attributed to participant risk conditions.

Objective: The Patient Health Questionnaire-9 (PHQ-9) is a widely used self-report measure of depression whose psychometric properties were found to be merely acceptable. Insufficient attention has been devoted to its clinimetric validity, while its clinical utility is still debated, particularly for assessing depression severity. This is the first study to test the PHQ-9 construct validity and clinical utility based on clinimetric principles.

Methods: An online survey of 3,398 participants was conducted. Item response theory models (Rasch and Mokken analyses) were used to assess the PHQ-9 validity and determine its clinical utility.

Results: Fit to the Rasch model was achieved after adjusting the sample size. Items 2, 4, 6, and 9 over-discriminated, while items 1, 5, and 7 under-discriminated. Local dependency between items 2 and 6 was indicated. The PHQ-9 was not unidimensional. A Loevinger's coefficient of 0.49 was found, indicating an acceptable level of scalability.

Conclusion: The PHQ-9 is an instrument with potential clinical utility as an overall index of depression, mainly for screening purposes. Substantial revision, particularly in the wording of over- and under-discriminating items, is needed.

Objective: To evaluate the effectiveness of online group cognitive behavioral therapy (CBT) based on the CAMALEO TOC manual in the treatment of adolescents with obsessive-compulsive disorder (OCD).

Methods: This is a quasi-experimental study with a single-group pretest-posttest intervention. Over a 12-week period, 11 adolescents aged 11 to 17 years with OCD participated in weekly online group CBT sessions based on the CAMALEO TOC manual. We used several assessment tools, including the Children's Yale-Brown Obsessive-Compulsive Scale to assess the severity of OCD symptoms, the Family Accommodation Scale for Obsessive-Compulsive Disorder-Interviewer-Rated to measure family accommodation, the Children's Depression Inventory to assess depression symptoms, the Revised Children's Manifest Anxiety Scale to assess anxiety, and the Multidimensional Students' Life Satisfaction Scale to measure satisfaction with life.

Results: OCD symptoms decreased significantly (d = -1.55) after online group CBT, and a strong effect size (d = -1.03) was found for family accommodation. After controlling for variables (e.g., engagement in psychotherapeutic treatment, medication use, or psychiatric comorbidities), no significant differences were found for OCD symptoms and family accommodation scores. In addition, there was insufficient evidence to support the effectiveness of online group CBT in reducing symptoms of depression or anxiety or improving overall quality of life.

Conclusion: Our study demonstrates the feasibility of short-term online group CBT as an effective therapeutic approach for adolescents with OCD.

Objective: Evidence on the relationship between depression and clinical dimensions of schizophrenia remains limited. This cross-sectional study investigated the association between depression and Positive and Negative Syndrome Scale (PANSS) dimensions in people with schizophrenia spectrum disorders.

Methods: Trained assessors administered the PANSS to measure symptoms of schizophrenia and the Calgary Depression Scale for Schizophrenia to measure depression. The association of depression with overall PANSS score and related dimensions was investigated in multiple logistic regression analyses.

Results: We included 231 inpatients with schizophrenia spectrum disorders (mean age: 42.4 (SD: 12.9) years; men: 58.9%; mean overall PANSS score: 82.5 (SD: 20.1); drug-free or naïve: 39.3%), including 78 (33.8%) with clinically significant depressive symptoms. Depression was associated with higher overall (regression coefficient, SE: 0.029, 0.008; p < 0.001) and general psychopathology (regression coefficient, SE: 0.118, 0.023; p < 0.001) PANSS scores. We found an inverse relationship between depression and positive symptoms (regression coefficient, SE: -0.088, 0.028; p = 0.002). No association between depression and negative symptoms was found.

Conclusion: Despite some limitations, our study shows that people affected by schizophrenia spectrum disorders with depression are likely to show more overall and general psychopathology symptoms but lower positive symptoms. Additional studies are needed to explore the generalizability of our findings.