Background: The interplay between inflammation, immune dysregulation, and the onset of neurological disorders, including epilepsy, has become increasingly recognized. Interleukin (IL)-6, a pro-inflammatory cytokine, is suspected to not only mediate traditional inflammatory pathways but also contribute to neuroinflammatory responses that could underpin neuropsychiatric symptoms and broader psychiatric disorders in epilepsy patients. The role of IL-6 receptor (IL6R) blockade presents an intriguing target for therapeutic intervention due to its potential to attenuate these processes.
Aim: To explore the potential of IL6R blockade in reducing the risk of epilepsy and investigate whether this pathway might also influence associated psychiatric and neuropsychiatric conditions due to neuroinflammation.
Methods: Mendelian randomization (MR) analysis employing single nucleotide polymorphisms (SNPs) in the vicinity of the IL6R gene (total individuals = 408225) was used to evaluate the putative causal relationship between IL6R blockade and epilepsy (total cases/controls = 12891/312803), focal epilepsy (cases/controls = 7526/399290), and generalized epilepsy (cases/controls = 1413/399287). SNP weights were determined by their effect on C-reactive protein (CRP) levels and integrated using inverse variance-weighted meta-analysis as surrogates for IL6R effects. To address potential outlier and pleiotropic influences, sensitivity analyses were conducted employing a variety of MR methods under different modeling assumptions.
Results: The genetic simulation targeting IL6R blockade revealed a modest but significant reduction in overall epilepsy risk [inverse variance weighting: Odds ratio (OR): 0.827; 95% confidence interval (CI): 0.685-1.000; P = 0.05]. Subtype analysis showed variability, with no significant effect observed in generalized, focal, or specific childhood and juvenile epilepsy forms. Beyond the primary inflammatory marker CRP, the findings also suggested potential non-inflammatory pathways mediated by IL-6 signaling contributing to the neurobiological landscape of epilepsy, hinting at possible links to neuroinflammation, psychiatric symptoms, and associated mental disorders.
Conclusion: The investigation underscored a tentative causal relationship between IL6R blockade and decreased epilepsy incidence, likely mediated via complex neuroinflammatory pathways. These results encouraged further in-depth studies involving larger cohorts and multifaceted psychiatric assessments to corroborate these findings and more thoroughly delineate the neuro-psychiatric implications of IL-6 signaling in epilepsy. The exploration of IL6R blockade could herald a novel therapeutic avenue not just for seizure management but also for addressing the broader psychiatric and cognitive disturbances
{"title":"Exploring the role of interleukin-6 receptor blockade in epilepsy and associated neuropsychiatric conditions through a mendelian randomization study.","authors":"Yan-Mei Yu, Gui-Hong Jin, Chong Zhong, Hao Qian, Lei Wang, Feng Zhan","doi":"10.5498/wjp.v14.i8.1244","DOIUrl":"10.5498/wjp.v14.i8.1244","url":null,"abstract":"<p><strong>Background: </strong>The interplay between inflammation, immune dysregulation, and the onset of neurological disorders, including epilepsy, has become increasingly recognized. Interleukin (IL)-6, a pro-inflammatory cytokine, is suspected to not only mediate traditional inflammatory pathways but also contribute to neuroinflammatory responses that could underpin neuropsychiatric symptoms and broader psychiatric disorders in epilepsy patients. The role of IL-6 receptor (<i>IL6R</i>) blockade presents an intriguing target for therapeutic intervention due to its potential to attenuate these processes.</p><p><strong>Aim: </strong>To explore the potential of <i>IL6R</i> blockade in reducing the risk of epilepsy and investigate whether this pathway might also influence associated psychiatric and neuropsychiatric conditions due to neuroinflammation.</p><p><strong>Methods: </strong>Mendelian randomization (MR) analysis employing single nucleotide polymorphisms (SNPs) in the vicinity of the <i>IL6R</i> gene (total individuals = 408225) was used to evaluate the putative causal relationship between <i>IL6R</i> blockade and epilepsy (total cases/controls = 12891/312803), focal epilepsy (cases/controls = 7526/399290), and generalized epilepsy (cases/controls = 1413/399287). SNP weights were determined by their effect on C-reactive protein (CRP) levels and integrated using inverse variance-weighted meta-analysis as surrogates for <i>IL6R</i> effects. To address potential outlier and pleiotropic influences, sensitivity analyses were conducted employing a variety of MR methods under different modeling assumptions.</p><p><strong>Results: </strong>The genetic simulation targeting <i>IL6R</i> blockade revealed a modest but significant reduction in overall epilepsy risk [inverse variance weighting: Odds ratio (OR): 0.827; 95% confidence interval (CI): 0.685-1.000; <i>P</i> = 0.05]. Subtype analysis showed variability, with no significant effect observed in generalized, focal, or specific childhood and juvenile epilepsy forms. Beyond the primary inflammatory marker CRP, the findings also suggested potential non-inflammatory pathways mediated by IL-6 signaling contributing to the neurobiological landscape of epilepsy, hinting at possible links to neuroinflammation, psychiatric symptoms, and associated mental disorders.</p><p><strong>Conclusion: </strong>The investigation underscored a tentative causal relationship between <i>IL6R</i> blockade and decreased epilepsy incidence, likely mediated <i>via</i> complex neuroinflammatory pathways. These results encouraged further in-depth studies involving larger cohorts and multifaceted psychiatric assessments to corroborate these findings and more thoroughly delineate the neuro-psychiatric implications of IL-6 signaling in epilepsy. The exploration of <i>IL6R</i> blockade could herald a novel therapeutic avenue not just for seizure management but also for addressing the broader psychiatric and cognitive disturbances ","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patients with hematological tumors experience physical and psychological stress, and negative psychological states. Baduanjin, an emerging psychological rehabilitation method combined with resistance exercise, has received widespread attention. This study reviews the current status of the application of Baduanjin combined with resistance exercise in improving the negative psychological state of patients with hematological tumors and discusses its problems and prospects. Through a literature review and comprehensive analysis, the application of Baduanjin and resistance exercise in the psychological rehabilitation of patients with hematological tumors was identified and evaluated. The results showed that Baduanjin with resistance exercise had a positive effect on improving negative psychological states of patients with hematological tumors, which can alleviate anxiety, depression, and other adverse emotions, and improve quality of life. However, there is a lack of unified and standardized exercise intervention programs for practical application, and patient participation and compliance must be improved. Baduanjin combined with resistance exercise can potentially improve the negative psychological status of patients with hematological tumors; however, it is still necessary to further standardize and improve the exercise program improving patient participation and compliance. Future studies should strengthen theoretical exploration and empirical research, providing more effective psychological rehabilitation strategies for patients with hematological tumors.
{"title":"Review of Baduanjin and resistance exercise for the mental health of patients with hematologic malignancies.","authors":"Ya-Zhou Shen, Feng Chen, Jia-Wen Yu, Yan Zhang, Ling-Xiang Lu, Yong-Li Huo, Si-Ting Chu, Bing Cao, Lei-Wen Tang","doi":"10.5498/wjp.v14.i8.1165","DOIUrl":"10.5498/wjp.v14.i8.1165","url":null,"abstract":"<p><p>Patients with hematological tumors experience physical and psychological stress, and negative psychological states. Baduanjin, an emerging psychological rehabilitation method combined with resistance exercise, has received widespread attention. This study reviews the current status of the application of Baduanjin combined with resistance exercise in improving the negative psychological state of patients with hematological tumors and discusses its problems and prospects. Through a literature review and comprehensive analysis, the application of Baduanjin and resistance exercise in the psychological rehabilitation of patients with hematological tumors was identified and evaluated. The results showed that Baduanjin with resistance exercise had a positive effect on improving negative psychological states of patients with hematological tumors, which can alleviate anxiety, depression, and other adverse emotions, and improve quality of life. However, there is a lack of unified and standardized exercise intervention programs for practical application, and patient participation and compliance must be improved. Baduanjin combined with resistance exercise can potentially improve the negative psychological status of patients with hematological tumors; however, it is still necessary to further standardize and improve the exercise program improving patient participation and compliance. Future studies should strengthen theoretical exploration and empirical research, providing more effective psychological rehabilitation strategies for patients with hematological tumors.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Precision medicine is transforming psychiatric treatment by tailoring personalized healthcare interventions based on clinical, genetic, environmental, and lifestyle factors to optimize medication management. This study investigates how artificial intelligence (AI) and machine learning (ML) can address key challenges in integrating pharmacogenomics (PGx) into psychiatric care. In this integration, AI analyzes vast genomic datasets to identify genetic markers linked to psychiatric conditions. AI-driven models integrating genomic, clinical, and demographic data demonstrated high accuracy in predicting treatment outcomes for major depressive disorder and bipolar disorder. This study also examines the pressing challenges and provides strategic directions for integrating AI and ML in genomic psychiatry, highlighting the importance of ethical considerations and the need for personalized treatment. Effective implementation of AI-driven clinical decision support systems within electronic health records is crucial for translating PGx into routine psychiatric care. Future research should focus on developing enhanced AI-driven predictive models, privacy-preserving data exchange, and robust informatics systems to optimize patient outcomes and advance precision medicine in psychiatry.
精准医疗正在改变精神病治疗，它根据临床、遗传、环境和生活方式等因素量身定制个性化医疗干预措施，以优化药物管理。本研究探讨了人工智能（AI）和机器学习（ML）如何应对将药物基因组学（PGx）整合到精神病治疗中的关键挑战。在这种整合中，人工智能分析庞大的基因组数据集，以确定与精神疾病相关的遗传标记。人工智能驱动的模型整合了基因组、临床和人口统计学数据，在预测重度抑郁症和双相情感障碍的治疗结果方面表现出了很高的准确性。本研究还探讨了在基因组精神病学中整合人工智能和 ML 所面临的紧迫挑战并提供了战略方向，强调了伦理考虑因素的重要性和个性化治疗的必要性。在电子健康记录中有效实施人工智能驱动的临床决策支持系统对于将 PGx 转化为常规精神病治疗至关重要。未来的研究应侧重于开发增强型人工智能驱动预测模型、保护隐私的数据交换和强大的信息系统，以优化患者预后并推进精神病学中的精准医疗。
{"title":"Challenges and prospects in bridging precision medicine and artificial intelligence in genomic psychiatric treatment.","authors":"Uchenna Esther Okpete, Haewon Byeon","doi":"10.5498/wjp.v14.i8.1148","DOIUrl":"10.5498/wjp.v14.i8.1148","url":null,"abstract":"<p><p>Precision medicine is transforming psychiatric treatment by tailoring personalized healthcare interventions based on clinical, genetic, environmental, and lifestyle factors to optimize medication management. This study investigates how artificial intelligence (AI) and machine learning (ML) can address key challenges in integrating pharmacogenomics (PGx) into psychiatric care. In this integration, AI analyzes vast genomic datasets to identify genetic markers linked to psychiatric conditions. AI-driven models integrating genomic, clinical, and demographic data demonstrated high accuracy in predicting treatment outcomes for major depressive disorder and bipolar disorder. This study also examines the pressing challenges and provides strategic directions for integrating AI and ML in genomic psychiatry, highlighting the importance of ethical considerations and the need for personalized treatment. Effective implementation of AI-driven clinical decision support systems within electronic health records is crucial for translating PGx into routine psychiatric care. Future research should focus on developing enhanced AI-driven predictive models, privacy-preserving data exchange, and robust informatics systems to optimize patient outcomes and advance precision medicine in psychiatry.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
João Mauricio Castaldelli-Maia, Nicolas Kohatsu Matakas
In this editorial, we comment on the article Adolescent suicide risk factors and the integration of social-emotional skills in school-based prevention programs by Liu et al. While the article focused on the issue of suicide and social-emotional learning programs as a possible intervention, we here discuss evidence of other reported outcomes and if it could be an effective way to prevent substance abuse among adolescents.
{"title":"Could school programs based on social-emotional learning prevent substance abuse among adolescents?","authors":"João Mauricio Castaldelli-Maia, Nicolas Kohatsu Matakas","doi":"10.5498/wjp.v14.i8.1143","DOIUrl":"10.5498/wjp.v14.i8.1143","url":null,"abstract":"<p><p>In this editorial, we comment on the article Adolescent suicide risk factors and the integration of social-emotional skills in school-based prevention programs by Liu <i>et al</i>. While the article focused on the issue of suicide and social-emotional learning programs as a possible intervention, we here discuss evidence of other reported outcomes and if it could be an effective way to prevent substance abuse among adolescents.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11331389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142010224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND Patients not only experience symptoms caused by cancer but also suffer from the accompanying psychological pain. Therefore, these patients do not have high quality of life. According to the World Health Organization, the incidence of leukemia in China in 2020 was 5.1/100000, the mortality rate was 3.3/100000, and the prevalence rate was 16.7/100000. Therefore, it is important to examine the influence of comorbid subthreshold depressive symptoms on leukemia patients. AIM To determine the impact of comorbid subthreshold depressive symptoms on cancer-related fatigue and complications in leukemia patients, thereby providing a basis for early diagnosis and treatment in clinical practice. METHODS A questionnaire survey was conducted among leukemia patients admitted to a tertiary hospital in Xi'an, Shaanxi Province, China, from August 2022 to December 2023. Patients with a score > 16 on the Chinese Classification of Mental Disorders (CCMD-3) and a Hamilton Depression Rating Scale score of 8-17 were classified as the subthreshold depressive group (n = 95), while 100 leukemia patients admitted during the same period were classified as the control group. Data were collected using Epidata 3.1 software, and comparisons were made between the two groups regarding general clinical data, the Piper Fatigue Scale (PFS), the Pittsburgh Sleep Quality Index (PSQI), the Numeric Rating Scale for pain assessment, laboratory indicators, and the occurrence of complications. RESULTS In this survey, 120 leukemia patients with depression were preliminarily screened, 95 patients with subthreshold depression were ultimately selected as the subthreshold depression group, and 100 leukemia patients admitted during the same period were enrolled as the normal group. Comparison of basic clinical data between the two groups revealed no significant differences in age, sex, body mass index, cognitive function, or comorbidity with other chronic diseases. However, there were statistically significant differences in the use of radiotherapy and regular exercise between the two groups (P < 0.05). Comparisons of scales and laboratory indicators revealed no significant differences in albumin or PSQI scores between the two groups, but there were statistically significant differences in pain scores, PSQI scores, PFS scores, hemoglobin levels, and C-reactive protein levels (P < 0.05). Spearman’s correlation analysis indicated that cancer-related fatigue was correlated with age, hemoglobin levels, C-reactive protein levels, pain, and regular exercise among leukemia patients with subthreshold depression. Multivariate regression analysis revealed that advanced age, combined radiotherapy, pain, and low hemoglobin levels were risk factors for cancer-related fatigue in leukemia patients with comorbid subthreshold depression, while regular exercise was a protective factor against cancer-related fatigue. Follow-up comparisons revealed a significantly lower overall incidence of complica
{"title":"Impact of comorbid subthreshold depressive symptoms on cancer-related fatigue and complications in adults with leukemia","authors":"Yue-Xian Liu, Juan Wang","doi":"10.5498/wjp.v14.i7.1009","DOIUrl":"https://doi.org/10.5498/wjp.v14.i7.1009","url":null,"abstract":"BACKGROUND\u0000 Patients not only experience symptoms caused by cancer but also suffer from the accompanying psychological pain. Therefore, these patients do not have high quality of life. According to the World Health Organization, the incidence of leukemia in China in 2020 was 5.1/100000, the mortality rate was 3.3/100000, and the prevalence rate was 16.7/100000. Therefore, it is important to examine the influence of comorbid subthreshold depressive symptoms on leukemia patients.\u0000 AIM\u0000 To determine the impact of comorbid subthreshold depressive symptoms on cancer-related fatigue and complications in leukemia patients, thereby providing a basis for early diagnosis and treatment in clinical practice.\u0000 METHODS\u0000 A questionnaire survey was conducted among leukemia patients admitted to a tertiary hospital in Xi'an, Shaanxi Province, China, from August 2022 to December 2023. Patients with a score > 16 on the Chinese Classification of Mental Disorders (CCMD-3) and a Hamilton Depression Rating Scale score of 8-17 were classified as the subthreshold depressive group (n = 95), while 100 leukemia patients admitted during the same period were classified as the control group. Data were collected using Epidata 3.1 software, and comparisons were made between the two groups regarding general clinical data, the Piper Fatigue Scale (PFS), the Pittsburgh Sleep Quality Index (PSQI), the Numeric Rating Scale for pain assessment, laboratory indicators, and the occurrence of complications.\u0000 RESULTS\u0000 In this survey, 120 leukemia patients with depression were preliminarily screened, 95 patients with subthreshold depression were ultimately selected as the subthreshold depression group, and 100 leukemia patients admitted during the same period were enrolled as the normal group. Comparison of basic clinical data between the two groups revealed no significant differences in age, sex, body mass index, cognitive function, or comorbidity with other chronic diseases. However, there were statistically significant differences in the use of radiotherapy and regular exercise between the two groups (P < 0.05). Comparisons of scales and laboratory indicators revealed no significant differences in albumin or PSQI scores between the two groups, but there were statistically significant differences in pain scores, PSQI scores, PFS scores, hemoglobin levels, and C-reactive protein levels (P < 0.05). Spearman’s correlation analysis indicated that cancer-related fatigue was correlated with age, hemoglobin levels, C-reactive protein levels, pain, and regular exercise among leukemia patients with subthreshold depression. Multivariate regression analysis revealed that advanced age, combined radiotherapy, pain, and low hemoglobin levels were risk factors for cancer-related fatigue in leukemia patients with comorbid subthreshold depression, while regular exercise was a protective factor against cancer-related fatigue. Follow-up comparisons revealed a significantly lower overall incidence of complica","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141639695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND Major depressive disorder (MDD) in adolescents and young adults contributes significantly to global morbidity, with inconsistent findings on brain structural changes from structural magnetic resonance imaging studies. Activation likelihood estimation (ALE) offers a method to synthesize these diverse findings and identify consistent brain anomalies. AIM To identify consistent brain structural changes in adolescents and young adults with MDD using ALE meta-analysis. METHODS We performed a comprehensive literature search in PubMed, Web of Science, Embase, and Chinese National Knowledge Infrastructure databases for neuroimaging studies on MDD among adolescents and young adults published up to November 19, 2023. Two independent researchers performed the study selection, quality assessment, and data extraction. The ALE technique was employed to synthesize findings on localized brain function anomalies in MDD patients, which was supplemented by sensitivity analyses. RESULTS Twenty-two studies comprising fourteen diffusion tensor imaging (DTI) studies and eight voxel-based morphometry (VBM) studies, and involving 451 MDD patients and 465 healthy controls (HCs) for DTI and 664 MDD patients and 946 HCs for VBM, were included. DTI-based ALE demonstrated significant reductions in fractional anisotropy (FA) values in the right caudate head, right insula, and right lentiform nucleus putamen in adolescents and young adults with MDD compared to HCs, with no regions exhibiting increased FA values. VBM-based ALE did not demonstrate significant alterations in gray matter volume. Sensitivity analyses highlighted consistent findings in the right caudate head (11 of 14 analyses), right insula (10 of 14 analyses), and right lentiform nucleus putamen (11 of 14 analyses). CONCLUSION Structural alterations in the right caudate head, right insula, and right lentiform nucleus putamen in young MDD patients may contribute to its recurrent nature, offering insights for targeted therapies.
{"title":"Multimodal abnormalities of brain structures in adolescents and young adults with major depressive disorder: An activation likelihood estimation meta-analysis","authors":"Yan-Ping Shu, Qin Zhang, Yongzhe Hou, Shuang Liang, Zu-Li Zheng, Jia-Lin Li, Gang Wu","doi":"10.5498/wjp.v14.i7.1106","DOIUrl":"https://doi.org/10.5498/wjp.v14.i7.1106","url":null,"abstract":"BACKGROUND\u0000 Major depressive disorder (MDD) in adolescents and young adults contributes significantly to global morbidity, with inconsistent findings on brain structural changes from structural magnetic resonance imaging studies. Activation likelihood estimation (ALE) offers a method to synthesize these diverse findings and identify consistent brain anomalies.\u0000 AIM\u0000 To identify consistent brain structural changes in adolescents and young adults with MDD using ALE meta-analysis.\u0000 METHODS\u0000 We performed a comprehensive literature search in PubMed, Web of Science, Embase, and Chinese National Knowledge Infrastructure databases for neuroimaging studies on MDD among adolescents and young adults published up to November 19, 2023. Two independent researchers performed the study selection, quality assessment, and data extraction. The ALE technique was employed to synthesize findings on localized brain function anomalies in MDD patients, which was supplemented by sensitivity analyses.\u0000 RESULTS\u0000 Twenty-two studies comprising fourteen diffusion tensor imaging (DTI) studies and eight voxel-based morphometry (VBM) studies, and involving 451 MDD patients and 465 healthy controls (HCs) for DTI and 664 MDD patients and 946 HCs for VBM, were included. DTI-based ALE demonstrated significant reductions in fractional anisotropy (FA) values in the right caudate head, right insula, and right lentiform nucleus putamen in adolescents and young adults with MDD compared to HCs, with no regions exhibiting increased FA values. VBM-based ALE did not demonstrate significant alterations in gray matter volume. Sensitivity analyses highlighted consistent findings in the right caudate head (11 of 14 analyses), right insula (10 of 14 analyses), and right lentiform nucleus putamen (11 of 14 analyses).\u0000 CONCLUSION\u0000 Structural alterations in the right caudate head, right insula, and right lentiform nucleus putamen in young MDD patients may contribute to its recurrent nature, offering insights for targeted therapies.","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141639696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zhi-Juan Lu, Jin-Xing Lai, Jing-Ru Huang, Shu-Hua Xie, Zhao-Hui Lai
BACKGROUND Intracranial high-density areas (HDAs) have attracted considerable attention for predicting clinical outcomes; however, whether HDAs predict worse neurological function and mental health remains controversial and unclear, which requires further investigation. AIM To investigate the predictive value of intracranial HDAs for neurological function and mental health after endovascular treatment. METHODS In this prospective study, 96 patients with acute ischemic stroke (AIS) who accepted endovascular mechanical thrombectomy (EMT) were included. The enrolled patients underwent cranial computed tomography (CT) examination within 24 hours after EMT. Clinical data in terms of National Institutes of Health Stroke Scale (NIHSS), the 3-month modified Rankin Scale (mRS), self-rating depression scale (SDS), and self-rating anxiety scale (SAS) scores were collected and compared between patients with HDAs and non-HDAs and between patients with good and poor clinical prognosis. RESULTS Compared to patients without HDAs, patients with HDAs presented severe neurological deficits (admission NIHSS score: 18 ± 3 vs 19 ± 4), were more likely to have post-stroke disabilities (mRS < 3: 35% vs 62%), and suffered more severe depression (SDS score: 58 ± 16 vs 64 ± 13) and anxiety disorder (SAS score: 52 ± 8 vs 59 ± 10). Compared to patients with a good prognosis, patients with a poor prognosis presented severe neurological deficits (admission NIHSS score: 17 ± 4 vs 20 ± 3), were more likely to have HDAs on CT images (64% vs 33%), and suffered more severe depression (SDS score: 55 ± 19 vs 65 ± 11) and anxiety (SAS score: 50 ± 8 vs 58 ± 12). Multivariate analysis revealed that HDAs were independent negative prognostic factors. CONCLUSION In conclusion, HDAs on CT images predicted poor prognosis and severe depressive and anxiety symptoms in patients with AIS who underwent EMT.
背景 颅内高密度区（HDAs）在预测临床结果方面引起了广泛关注；然而，HDAs 是否能预测神经功能和精神健康状况的恶化仍存在争议且不明确，需要进一步研究。目的 探讨颅内 HDA 对血管内治疗后神经功能和心理健康的预测价值。方法 在这项前瞻性研究中，纳入了 96 名接受血管内机械取栓术（EMT）的急性缺血性卒中（AIS）患者。患者在接受 EMT 治疗后 24 小时内接受了头颅计算机断层扫描（CT）检查。收集美国国立卫生研究院卒中量表（NIHSS）、3 个月改良 Rankin 量表（mRS）、抑郁自评量表（SDS）和焦虑自评量表（SAS）评分等临床数据，并对 HDA 患者和非 HDA 患者以及临床预后良好和不良的患者进行比较。结果 与非 HDAs 患者相比，HDAs 患者表现出严重的神经功能缺损（入院 NIHSS 评分：18 ± 3 vs 19 ± 4），更有可能出现卒中后残疾（mRS < 3：35% vs 62%），患有更严重的抑郁症（SDS 评分：58 ± 16 vs 64 ± 13）和焦虑症（SAS 评分：52 ± 8 vs 59 ± 10）。与预后良好的患者相比，预后不良的患者表现出严重的神经功能缺损（入院NIHSS评分：17 ± 4 vs 20 ± 3），更有可能在CT图像上出现HDA（64% vs 33%），患有更严重的抑郁症（SDS评分：55 ± 19 vs 65 ± 11）和焦虑症（SAS评分：50 ± 8 vs 58 ± 12）。多变量分析显示，HDA 是独立的预后不良因素。结论 总之，在接受 EMT 的 AIS 患者中，CT 图像上的 HDA 预示着不良预后以及严重的抑郁和焦虑症状。
{"title":"Predictive value of intracranial high-density areas in neurological function","authors":"Zhi-Juan Lu, Jin-Xing Lai, Jing-Ru Huang, Shu-Hua Xie, Zhao-Hui Lai","doi":"10.5498/wjp.v14.i7.1080","DOIUrl":"https://doi.org/10.5498/wjp.v14.i7.1080","url":null,"abstract":"BACKGROUND\u0000 Intracranial high-density areas (HDAs) have attracted considerable attention for predicting clinical outcomes; however, whether HDAs predict worse neurological function and mental health remains controversial and unclear, which requires further investigation.\u0000 AIM\u0000 To investigate the predictive value of intracranial HDAs for neurological function and mental health after endovascular treatment.\u0000 METHODS\u0000 In this prospective study, 96 patients with acute ischemic stroke (AIS) who accepted endovascular mechanical thrombectomy (EMT) were included. The enrolled patients underwent cranial computed tomography (CT) examination within 24 hours after EMT. Clinical data in terms of National Institutes of Health Stroke Scale (NIHSS), the 3-month modified Rankin Scale (mRS), self-rating depression scale (SDS), and self-rating anxiety scale (SAS) scores were collected and compared between patients with HDAs and non-HDAs and between patients with good and poor clinical prognosis.\u0000 RESULTS\u0000 Compared to patients without HDAs, patients with HDAs presented severe neurological deficits (admission NIHSS score: 18 ± 3 vs 19 ± 4), were more likely to have post-stroke disabilities (mRS < 3: 35% vs 62%), and suffered more severe depression (SDS score: 58 ± 16 vs 64 ± 13) and anxiety disorder (SAS score: 52 ± 8 vs 59 ± 10). Compared to patients with a good prognosis, patients with a poor prognosis presented severe neurological deficits (admission NIHSS score: 17 ± 4 vs 20 ± 3), were more likely to have HDAs on CT images (64% vs 33%), and suffered more severe depression (SDS score: 55 ± 19 vs 65 ± 11) and anxiety (SAS score: 50 ± 8 vs 58 ± 12). Multivariate analysis revealed that HDAs were independent negative prognostic factors.\u0000 CONCLUSION\u0000 In conclusion, HDAs on CT images predicted poor prognosis and severe depressive and anxiety symptoms in patients with AIS who underwent EMT.","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141639830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND Hormone replacement therapy is an effective treatment strategy for the management of symptoms in naturally menopausal women. However, some patients report experiencing adverse effects. AIM To analyze the effects of hormone replacement therapy in menopausal female patients. METHODS A total of 152 menopausal female patients admitted to the Gynecology Department of the Ganzhou Maternal and Child Health Hospital between January 2021 and December 2023 were divided into the observation group (n = 76, conventional treatment + hormone replacement therapy) and the control group (n = 76, conventional treatment only) via random casting. The improvement observed in the following items were compared between the groups: Kupperman menopausal index (KMI), emotional state [The Positive and Negative Affect Scale (PANAS)], sleep quality [Self-Rating Scale of Sleep (SRSS)], treatment effectiveness, and treatment safety. RESULTS The modified KMI and SRSS scores of the observation group were lower than those of the control group after three rounds of treatment. The improvement in the PANAS score observed in the observation group was greater than that observed in the control group (P < 0.05). The total treatment effectivity rate in the observation group was higher than that in the control group (86.84% vs 96.05%, χ 2 = 4.121, P = 0.042). The incidence rate of adverse reactions in the two groups was comparable (6.58% vs 9.21%, χ 2 = 0.361, P = 0.547). CONCLUSION Hormone replacement therapy effectively improved the clinical symptoms, actively channeled negative emotions, and improved the quality of sleep in menopausal patients, indicating its effectiveness and safety.
{"title":"Effects of hormone replacement therapy on mood and sleep quality in menopausal women","authors":"Qing Liu, Zhenlei Huang, Ping Xu","doi":"10.5498/wjp.v14.i7.1087","DOIUrl":"https://doi.org/10.5498/wjp.v14.i7.1087","url":null,"abstract":"BACKGROUND\u0000 Hormone replacement therapy is an effective treatment strategy for the management of symptoms in naturally menopausal women. However, some patients report experiencing adverse effects.\u0000 AIM\u0000 To analyze the effects of hormone replacement therapy in menopausal female patients.\u0000 METHODS\u0000 A total of 152 menopausal female patients admitted to the Gynecology Department of the Ganzhou Maternal and Child Health Hospital between January 2021 and December 2023 were divided into the observation group (n = 76, conventional treatment + hormone replacement therapy) and the control group (n = 76, conventional treatment only) via random casting. The improvement observed in the following items were compared between the groups: Kupperman menopausal index (KMI), emotional state [The Positive and Negative Affect Scale (PANAS)], sleep quality [Self-Rating Scale of Sleep (SRSS)], treatment effectiveness, and treatment safety.\u0000 RESULTS\u0000 The modified KMI and SRSS scores of the observation group were lower than those of the control group after three rounds of treatment. The improvement in the PANAS score observed in the observation group was greater than that observed in the control group (P < 0.05). The total treatment effectivity rate in the observation group was higher than that in the control group (86.84% vs 96.05%, χ 2 = 4.121, P = 0.042). The incidence rate of adverse reactions in the two groups was comparable (6.58% vs 9.21%, χ 2 = 0.361, P = 0.547).\u0000 CONCLUSION\u0000 Hormone replacement therapy effectively improved the clinical symptoms, actively channeled negative emotions, and improved the quality of sleep in menopausal patients, indicating its effectiveness and safety.","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141639687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND The risks associated with negative doctor-patient relationships have seriously hindered the healthy development of medical and healthcare and aroused widespread concern in society. The number of public comments on doctor-patient relationship risk events reflects the degree to which the public pays attention to such events. AIM To explore public emotional differences, the intensity of comments, and the positions represented at different levels of doctor-patient disputes. METHODS Thirty incidents of doctor-patient disputes were collected from Weibo and TikTok, and 3655 related comments were extracted. The number of comment sentiment words was extracted, and the comment sentiment value was calculated. The Kruskal-Wallis H test was used to compare differences between each variable group at different levels of incidence. Spearman’s correlation analysis was used to examine associations between variables. Regression analysis was used to explore factors influencing scores of comments on incidents. RESULTS The study results showed that public comments on media reports of doctor-patient disputes at all levels are mainly dominated by “good” and “disgust” emotional states. There was a significant difference in the comment scores and the number of partial emotion words between comments on varying levels of severity of doctor-patient disputes. The comment score was positively correlated with the number of emotion words related to positive, good, and happy) and negatively correlated with the number of emotion words related to negative, anger, disgust, fear, and sadness. CONCLUSION The number of emotion words related to negative, anger, disgust, fear, and sadness directly influences comment scores, and the severity of the incident level indirectly influences comment scores.
{"title":"Emotional differences based on comments on doctor-patient disputes with varying levels of severity","authors":"Jing-Ru Lu, Yu-Han Wei, Xin Wang, Yu-Qing Zhang, Jia-Yi Shao, Jiang-Jie Sun","doi":"10.5498/wjp.v14.i7.1068","DOIUrl":"https://doi.org/10.5498/wjp.v14.i7.1068","url":null,"abstract":"BACKGROUND\u0000 The risks associated with negative doctor-patient relationships have seriously hindered the healthy development of medical and healthcare and aroused widespread concern in society. The number of public comments on doctor-patient relationship risk events reflects the degree to which the public pays attention to such events.\u0000 AIM\u0000 To explore public emotional differences, the intensity of comments, and the positions represented at different levels of doctor-patient disputes.\u0000 METHODS\u0000 Thirty incidents of doctor-patient disputes were collected from Weibo and TikTok, and 3655 related comments were extracted. The number of comment sentiment words was extracted, and the comment sentiment value was calculated. The Kruskal-Wallis H test was used to compare differences between each variable group at different levels of incidence. Spearman’s correlation analysis was used to examine associations between variables. Regression analysis was used to explore factors influencing scores of comments on incidents.\u0000 RESULTS\u0000 The study results showed that public comments on media reports of doctor-patient disputes at all levels are mainly dominated by “good” and “disgust” emotional states. There was a significant difference in the comment scores and the number of partial emotion words between comments on varying levels of severity of doctor-patient disputes. The comment score was positively correlated with the number of emotion words related to positive, good, and happy) and negatively correlated with the number of emotion words related to negative, anger, disgust, fear, and sadness.\u0000 CONCLUSION\u0000 The number of emotion words related to negative, anger, disgust, fear, and sadness directly influences comment scores, and the severity of the incident level indirectly influences comment scores.","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141639686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND In the rapidly evolving landscape of psychiatric research, 2023 marked another year of significant progress globally, with the World Journal of Psychiatry (WJP ) experiencing notable expansion and influence. AIM To conduct a comprehensive visualization and analysis of the articles published in the WJP throughout 2023. By delving into these publications, the aim is to determine the valuable insights that can illuminate pathways for future research endeavors in the field of psychiatry. METHODS A selection process led to the inclusion of 107 papers from the WJP published in 2023, forming the dataset for the analysis. Employing advanced visualization techniques, this study mapped the knowledge domains represented in these papers. RESULTS The findings revealed a prevalent focus on key topics such as depression, mental health, anxiety, schizophrenia, and the impact of coronavirus disease 2019. Additionally, through keyword clustering, it became evident that these papers were predominantly focused on exploring mental health disorders, depression, anxiety, schizophrenia, and related factors. Noteworthy contributions hailed authors in regions such as China, the United Kingdom, United States, and Turkey. Particularly, the paper garnered the highest number of citations, while the American Psychiatric Association was the most cited reference. CONCLUSION It is recommended that the WJP continue in its efforts to enhance the quality of papers published in the field of psychiatry. Additionally, there is a pressing need to delve into the potential applications of digital interventions and artificial intelligence within the discipline.
{"title":"Research fronts and researchers of World Journal of Psychiatry in 2023: A visualization and analysis of mapping knowledge domains","authors":"Yun-Tian Xie, Yu-Jing Yang","doi":"10.5498/wjp.v14.i7.1118","DOIUrl":"https://doi.org/10.5498/wjp.v14.i7.1118","url":null,"abstract":"BACKGROUND\u0000 In the rapidly evolving landscape of psychiatric research, 2023 marked another year of significant progress globally, with the World Journal of Psychiatry (WJP ) experiencing notable expansion and influence.\u0000 AIM\u0000 To conduct a comprehensive visualization and analysis of the articles published in the WJP throughout 2023. By delving into these publications, the aim is to determine the valuable insights that can illuminate pathways for future research endeavors in the field of psychiatry.\u0000 METHODS\u0000 A selection process led to the inclusion of 107 papers from the WJP published in 2023, forming the dataset for the analysis. Employing advanced visualization techniques, this study mapped the knowledge domains represented in these papers.\u0000 RESULTS\u0000 The findings revealed a prevalent focus on key topics such as depression, mental health, anxiety, schizophrenia, and the impact of coronavirus disease 2019. Additionally, through keyword clustering, it became evident that these papers were predominantly focused on exploring mental health disorders, depression, anxiety, schizophrenia, and related factors. Noteworthy contributions hailed authors in regions such as China, the United Kingdom, United States, and Turkey. Particularly, the paper garnered the highest number of citations, while the American Psychiatric Association was the most cited reference.\u0000 CONCLUSION\u0000 It is recommended that the WJP continue in its efforts to enhance the quality of papers published in the field of psychiatry. Additionally, there is a pressing need to delve into the potential applications of digital interventions and artificial intelligence within the discipline.","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141639692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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