The primary care companion for CNS disorders最新文献

Objective: To explore depression prevalence, correlates, impact, and interventions in breast cancer patients, with a focus on the Indian context.

Data Sources: The search specifically targeted PubMed as the primary electronic database using keywords such as breast cancer, depression, and India. No date limits were imposed, and studies were restricted to those available in English.

Study Selection: A total of 12 studies were reviewed, comprising original research articles and case studies. Inclusion criteria encompassed studies investigating depression in breast cancer patients, irrespective of study design or intervention type.

Data Extraction: Data abstraction followed predefined guidelines, focusing on depression prevalence rates, factors associated with depression onset, intervention efficacy, and implications for clinical practice. Data were extracted independently by 2 reviewers, with discrepancies resolved through discussion.

Data Synthesis: Findings revealed diverse depression rates among breast cancer patients, ranging from 21.5% to 83.5%. Treatment type, body image concerns postsurgery, stigma, and sociodemographic factors such as low income, education, and rural residency were identified as contributors to depression onset. Nonpharmacologic interventions, particularly yoga and supportive psychotherapy, demonstrated efficacy in mitigating depression symptoms.

Conclusions: This review underscores the multifaceted nature of depression in breast cancer patients and the importance of tailored interventions to address this psychological comorbidity. Integration of mental health services into cancer care frameworks, alongside traditional treatment modalities, is essential to ensure comprehensive support for breast cancer patients. The findings advocate for a holistic approach to mental health within cancer care, emphasizing the need for policy initiatives that prioritize psychosocial well being alongside physical health outcomes.

Prim Care Companion CNS Disord 2024;26(5):24r03721.

Author affiliations are listed at the end of this article.

Objective: To investigate the relationship between social isolation and substance abuse among adult hospitalizations to better target prevention and intervention.

Methods: The 2018 National Inpatient Sample dataset was used to identify adult hospitalizations with social isolation and substance abuse in the United States, omitting long-term and rehabilitation facilities. The study analyzed sociodemographic features and health care resource utilization, with primary end points focusing on the prevalence of substance use disorder (SUD) with social isolation and sex/race-based disparities and secondary end points including mental health and costs. Comparisons were analyzed using SPSS Statistics with weighted data and complex survey modules.

Results: The study included 2,050 patients (median age: 48 years, male: 55.6%) with an International Classification of Diseases, Tenth Revision, Clinical Modification social isolation diagnostic code, of which 16.6% had SUD, with higher prevalence in those of younger age, male sex, and black race. Smoking (49.3% vs 36.1%), alcohol disorder (14.4% vs 4.9%), cannabis disorder (14.6% vs 1.4%), stimulant-related disorder (16.3% vs 2.6%), and opioid-related disorder (16.6% vs 3.1%) were the most prevalent SUDs among socially isolated patients. The length of stay was similar among socially isolated patients by substance use; however, hospitalization cost was higher ($6,144 vs $4,745) among patients with SUD.

Conclusion: The link between social isolation and substance use highlights the significance of addressing social isolation as a public health issue. Interventions to nurture social ties and reduce social isolation may have significant potential in preventing and managing SUDs.

Prim Care Companion CNS Disord 2024;26(5):23m03679.

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Objective: The association between childhood separation anxiety disorder (CSAD) and panic disorder (PD) has been demonstrated, although some findings are contradictory. The separation anxiety hypothesis postulates that both CSAD and PD encompass a heightened sensitivity to carbon dioxide (CO₂). Patients with the respiratory subtype (RS) of PD are known to be more sensitive to CO₂ than those from the nonrespiratory subtype (NRS). Therefore, the primary objective centered on the comparative analysis of CSAD prevalence between RS and NRS groups, with secondary objectives focusing on the comparative assessment of RS and NRS groups and the control group.

Methods: Sixty RS-PD patients, 60 NRS-PD patients, and 60 controls were assessed for retrospective diagnosis of CSAD between March 2020 and August 2023 using a diagnostic categorical instrument, DSM-5 criteria, and a dimensional one, the Separation Anxiety Symptom Inventory.

Results: RS patients had a significantly greater history of CSAD (55%) compared to the NRS (23%) and control (17%) groups (P < .001), which shows stronger association with the RS group. As seen in logistic regression, RS patients had 3.02 more chances of having CSAD when compared the NRS group and 5.11 when compared to the control group, which shows stronger association with the RS group.

Conclusion: This study supports the hypothesis that RS-PD is associated with CSAD, while there is a weak association between NRS-PD and CSAD. It is advisable for clinicians to screen individuals with RS-PD for symptoms of separation anxiety, as these symptoms may have a negative impact on the prognosis of PD.

Prim Care Companion CNS Disord 2024;26(5):24m03709.

Author affiliations are listed at the end of this article.