World Journal of Psychiatry最新文献

Gynecological cancers and their treatments are associated with both specific and non-specific long-term physiological effects. Cancer patients face transformations in their lifestyle, body image, role, and social interactions and suffer from physical, psychological, and economic problems. The mental health of cancer patients is of great importance and requires special attention, as growing evidence demonstrates its influence not only on quality of life but also on treatment compliance. Gynecological cancers have peculiar psychological consequences, which are linked to the specificity of the site of the neoplasia. Clinicians should be aware of the importance of protecting the psychophysical health of these patients and the fact that their physical health and quality of life also depend on the quality of their mental health. It is possible to structure targeted and effective prevention interventions and treatments to reduce psychological distress and improve the quality of life of subjects living with gynecological cancers.

Background: Electroconvulsive therapy (ECT) is both an effective treatment for patients with major depressive disorder (MDD) and a noxious stimulus. Although some studies have explored the effect of sedation depth on seizure parameters in ECT, there is little research on the noxious stimulation response to ECT. In this study, we used two electroencephalography (EEG)-derived indices, the quantitative consciousness (qCON) index and quantitative nociceptive (qNOX) index, to monitor sedation, hypnosis, and noxious stimulation response in patients with MDD undergoing acute ECT.

Aim: To evaluate the effect of anesthesia depth based on the qCON and qNOX indices on seizure parameters.

Methods: Patients with MDD (n = 24) underwent acute bilateral temporal ECT under propofol anesthesia. Before ECT, the patients were randomly divided into three groups according to qCON scores (qCON60-70, qCON50-60, and qCON40-50). Continuous qCON monitoring was performed 3 minutes before and during ECT, and the qCON, qNOX, vital signs, EEG seizure parameters, and complications during the recovery period were recorded. The 24-item Hamilton Rating Scale for Depression, Zung's Self-rating Depression Scale, and Montreal Cognitive Assessment scores were evaluated before the first ECT session, after the fourth ECT session, and after the full course of ECT.

Results: A total of 193 ECT sessions were performed on 24 participants. The qCON index significantly affected the EEG seizure duration, peak mid-ictal amplitude, and maximum heart rate during ECT (P < 0.05). The qNOX index significantly affected the post-ictal suppression index (P < 0.05). Age, number of ECT sessions, and anesthetic-ECT time intervals also had a significant effect on EEG seizure parameters (P < 0.05). However, there were no significant differences in complications, 24-item Hamilton Rating Scale for Depression scores, Zung's Self-rating Depression Scale scores, or Montreal Cognitive Assessment scores among the three groups (P > 0.05).

Conclusion: Electrical stimulation at a qCON index of 60-70 resulted in better EEG seizure parameters without increasing complications in patients with MDD undergoing bilateral temporal ECT under propofol anesthesia.

Background: To assess the effectiveness of Shugan Jieyu capsules on peripheral blood miR-124, miR-132, and brain-derived neurotrophic factor (BDNF) levels in patients with mild to moderate depression following coronary artery intervention [percutaneous coronary intervention (PCI)] for coronary heart disease.

Aim: To evaluate the therapeutic efficacy of Shugan Jieyu capsules and their effects on the peripheral blood levels of miR-124, miR-132, and BDNF in patients with mild to moderate depression following PCI for coronary heart disease.

Methods: Patients with mild-to-moderate depression of the liver-qi stagnation type after PCI for coronary heart disease at the 305^th Hospital of the People's Liberation Army were enrolled from June 2022 to November 2023 and randomly assigned to two groups: Experimental (treated with Shugan Jieyu capsules) and control (treated with escitalopram oxalate tablets). This study compared the antidepressant effects of these treatments using 17-item Hamilton Rating Scale for Depression (HAMD-17) scores, metabolic equivalents, low-density lipoprotein cholesterol, BDNF, high-sensitivity C-reactive protein levels, miR-124 and miR-132 levels, distribution of immune-related lymphocyte subsets, and traditional Chinese medicine syndrome scores before and after 6 weeks of treatment.

Results: No significant difference was observed in any index between the two groups before treatment (P > 0.05). After treatment, the total efficacy rates were 93.33% and 90.00% in the experimental and control groups, respectively. Experimental group had significantly lower scores for the main and secondary syndromes compared to the control group (P < 0.05). No significant difference was observed in the metabolic equivalents between the two groups before and after treatment (P > 0.05). The levels of low-density lipoprotein cholesterol, high-sensitivity C-reactive protein, and miR-132 were significantly lower, whereas those of miR-124, BDNF, CD3+T lymphocytes, CD3+CD4+T helper lymphocytes, and CD3+CD4+/CD3+CD8+ cells were significantly higher in the experimental group compared to the control group (P < 0.05). The incidence of adverse reactions during experimental group was significantly lower than that in control group (P < 0.05).

Conclusion: Shugan Jieyu capsules have good efficacy in patients with mild-to-moderate depression after PCI, and its mechanism may contribute to the regulation of miR-124, miR-132, BDNF levels, and lymphoid immune cells.

Background: Pediatric abdominal infection is a common but serious disease that requires timely and effective treatment. In surgical treatment, accurate diagnosis and rational application of antibiotics are the keys to improving treatment effects.

Aim: To investigate the effect of broad-spectrum bacterial detection on postoperative antibiotic therapy.

Methods: A total of 100 children with abdominal infection who received surgical treatment in our hospital from September 2020 to July 2021 were grouped. The observation group collected blood samples upon admission and sent them for broad-spectrum bacterial infection nucleic acid testing, and collected pus or exudate during the operation for bacterial culture and drug sensitivity testing; the control group only sent bacterial culture and drug sensitivity testing during the operation.

Results: White blood cell count, C-reactive protein, procalcitonin, 3 days after surgery, showed better postoperative index than the control group (P < 0.05). The hospital stay in the observation group was significantly shorter than that in the control group. The hospitalization cost in the observation group was significantly lower than that in the control group, and the difference between the two groups was statistically significant (P < 0.05).

Conclusion: Early detection of broad-spectrum bacterial infection nucleic acids in pediatric abdominal infections can help identify pathogens sooner and guide the appropriate use of antibiotics, improving treatment outcomes and reducing medical costs to some extent.

Background: Post-stroke depression (PSD) is a common and debilitating condition affecting stroke survivors, significantly impacting their recovery and overall quality of life.

Aim: To assess the effects of early PSD screening on functional outcomes, quality of life, and mortality.

Methods: From an initial pool of 1065 articles, 6 studies met the inclusion criteria and were selected for analysis. Functional outcomes were measured using the functional independence measure (FIM).

Results: The analysis revealed a significant improvement in FIM scores for a PSD screening group compared to controls [standardized mean difference (SMD) = 8.90, 95% confidence interval (CI): 4.65-13.15, P < 0.01]. Quality of life was assessed using the Stroke-Specific Quality of Life Scale, with the screening group showing significantly higher scores (SMD = 20.83, 95%CI: 15.27-26.38, P < 0.01). Mortality analysis indicated a reduction in five-year mortality rates for the PSD screening group.

Conclusion: Early PSD screening enhances functional recovery, improves quality of life, and reduces mortality rates in stroke survivors. Thus, integrating PSD screening into routine stroke care improves long-term outcomes for patients.

Background: Generalized anxiety disorder (GAD) is a relatively common mental disorder. Recently, inflammation, an important factor for the development of depression, has attracted increasing attention. Several studies have shown that inflammatory cytokines can affect the pathophysiological processes of several nervous system diseases. We hypothesized that there is a correlation between the levels of lipopolysaccharide (LPS)-stimulated inflammatory cytokines and the clinical symptoms of GAD.

Aim: To investigate the predictive effect of LPS-stimulated inflammatory cytokines on symptoms of GAD.

Methods: This was a cross-sectional study in which 89 patients with GAD diagnosed at The First Hospital of Hebei Medical University from January 2022 to December 2022 and 70 individuals without anxiety and depression (controls) during the same period were included. Fasting venous blood was collected from all the subjects in heparin tubes, and another 3 ml of blood was supplemented with LPS (10 ng/ml). The plasma levels of 12 cytokines [Interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, IL-17A, IL-12p70, and IFN-α] were detected.

Results: Post-LPS stimulation, the levels of IL-1β, IL-6, IL-8, IL-10, and TNF-α in both the control and GAD groups were significantly elevated above those in the nonstimulated groups, with IL-6 and IL-8 showing marked increases. Increases in IL-8 and TNF-α were statistically significant in the GAD group (P < 0.05). IL-1β, IL-6, IL-8, IL-10, and TNF-α were found to be significantly correlated with Hamilton Anxiety Rating Scale (HAMA) scores (P < 0.05). A negative correlation was observed between IL-10 levels and HAMA scores. Further analysis revealed that TNF-α was associated with mental anxiety, whereas IL-1β, IL-8, and IL-10 were associated with physical anxiety symptoms, with IL-10 showing a negative correlation with physical anxiety. IL-6 was associated with both mental and physical aspects of anxiety.

Conclusion: The physical symptoms of GAD are related to inflammatory factors. IL-1β, IL-8, IL-10, and TNF-a can be used as predictors of physical or mental anxiety in patients with GAD.

Depression and metabolic syndrome could exacerbate the risks of the other, leading to a series of severe coexisting conditions. One notable comorbidity that must be mentioned is obstructive sleep apnea (OSA). Current studies suggested that depression increases susceptibility to OSA. As the prevalence of depression rises, it becomes critical to prevent and manage its complications or comorbidities, including OSA. Predictive models, non-invasive electroencephalogram monitoring, genetic research, and other promising technologies are being applied to the prevention, diagnosis, and personalized treatment of depression and OSA.

Background: Programmed comprehensive nursing was adopted for intensive care unit (ICU) children following severe cardiac surgery to improve respiratory function and delirium incidence.

Aim: To explore how programmed comprehensive nursing impacts respiratory function and delirium incidence in ICU children post cardiac surgery.

Methods: Between January 2022 and January 2024, 180 pediatric patients from the Children's Hospital of Nanjing were admitted to the ICU after cardiac surgery and randomly grouped. The control group comprised 90 patients and received routine nursing care. The observation group comprised 90 patients and received programmed comprehensive nursing. Both groups received continuous nursing care until discharge. Their respiratory function, incidence of delirium, and clinical outcomes were compared. The memory state and sleep quality of both groups were compared.

Results: The incidence of delirium was 5.56% in the observation group when admitted to ICU, which was lower than that in the control group (20.00%; P < 0.05). The observation group demonstrated higher peak expiratory flow rate, respiratory frequency, deep breathing volume, and tidal volume in the ICU compared with the control group. Additionally, the observation group showed higher sleep depth, sleep latency, night awakening, return to sleep, and sleep quality compared with the control group (P < 0.05).

Conclusion: Programmed comprehensive nursing in ICU patients following severe cardiac surgery can reduce the impact on respiratory function, improve sleep quality, and alleviate postoperative delirium, showing significant promise for clinical application.

Background: The occurrence of postoperative depression and anxiety in patients with endometriosis (EMS) not only causes psychological distress, but may also harm their physical health.

Aim: To explore the postoperative depression status, and its influencing factors, of EMS patients with reproductive intention.

Methods: A total of 321 EMS patients with reproductive intent were included. Using the self-rating anxiety scale and self-rating depression scale, EMS patients with anxiety or depression were distinguished. A clinical model for predicting anxiety or depression in EMS patients was constructed and evaluated using a nomogram, receiver operating characteristic curve, and calibration curve.

Results: The results of the single factor analysis showed that smoking, coffee, EMS stage, chronic pelvic pain, and sexual discomfort may be related to anxiety. Further, smoking, drinking, spouse, annual household income and EMS stage may be related to depression in EMS patients. Multivariate logistic regression illustrated that smoking, coffee, chronic pelvic pain and sexual discomfort may be independent risk factors for anxiety in EMS patients, while smoking, EMS stage (Phase III and Phase IV), spouse and high annual household income may be independent risk factors for depression in EMS patients. Additionally, the models used to predict the risk of anxiety or depression in EMS patients have good predictive value.

Conclusion: The anxiety and depression of EMS patients may be related to many factors. In clinical treatment, additional attention should be paid to the psychological status of EMS patients.