World Journal of Psychiatry最新文献

In this editorial, we comment on the study of the Yu et al on psychological distress in patients with hepatobiliary and pancreatic malignancies. Hepatobiliary and pancreatic malignancies include hepatocellular carcinoma, cholangiocarcinoma, gallbladder cancer and pancreatic cancer. These cancers are among the most aggressive and difficult to treat. Although improvements in surgery, drug treatments and palliative care have led to better survival rates and quality of life, the significant psychological impact on patients remains underrecognized. Anxiety and depression are prevalent at every stage of the disease, from the initial diagnosis to treatment, recurrence and end-of-life care. However, these issues often take a backseat to the urgent need to manage physical symptoms. Mental health challenges can greatly affect how well patients follow treatment plans, recover and their overall outlook. Yu et al explore the causes of psychological distress in hepatobiliary and pancreatic cancers, including disease severity, symptom burden, financial stress and fears about life and death. We highlight the importance of regular mental health screenings, psychological support and teamwork in oncology care. By focusing on emotional health alongside physical treatment, doctors can build resilience, improve outcomes and address a frequently ignored aspect of cancer care.

Background: Esophageal cancer is highly malignant and frequently metastasizes to bones. Concomitant depression worsens prognosis; however, its incidence and determinants in this specific population remain poorly defined.

Aim: To determine the incidence of depression and its independent risk factors in patients with esophageal cancer and bone metastasis.

Methods: A total of 100 consecutive eligible patients admitted between March 2022 and March 2025 were recruited. Depression was assessed with the Beck Depression Inventory-II; scores > 4 defined the depression group (n = 42) and scores ≤ 4 the non-depression group (n = 58). Demographic, clinical, and laboratory variables were compared between the groups. Multivariate logistic regression was used to identify independent risk factors.

Results: Depression prevalence was 42.0% (42/100). Univariate analysis demonstrated significant differences in monthly per-capita household income, education level, social support, sleep disorders, and serum high-sensitivity C-reactive protein (all P < 0.05); no differences were observed in sex, age, tumor characteristics, or other laboratory indices (all P > 0.05). Multivariable analysis revealed the following independent risk factors for depression: Low income [odds ratio (OR) = 2.66, 95% confidence interval (CI): 1.17-6.03], low education (OR = 2.46, 95%CI: 1.08-5.61), low social support (OR = 5.10, 95%CI: 1.81-14.39), sleep disorders (OR = 2.79, 95%CI: 1.23-6.35), and elevated high-sensitivity C-reactive protein (OR = 1.31 per unit increase, 95%CI: 1.18-1.46).

Conclusion: Depression is common among patients with esophageal cancer and bone metastasis. Low socioeconomic status, limited education, insufficient social support, sleep disturbances, and systemic inflammation were independent predictors. Interventions that address these modifiable factors may reduce depression risk in this population.

Background: Long-term antipsychotic therapy in psychiatric patients carries significant cardiovascular risks, including QT interval prolongation, myocardial injury, and functional impairment. Guanxinning, a traditional Chinese medicine formulation, has demonstrated cardioprotective potential in preclinical studies, but clinical evidence in this population remains limited.

Aim: To evaluate the cardioprotective effects of Guanxinning against antipsychotic-induced cardiac injury in long-term hospitalized psychiatric patients.

Methods: A randomized, double-blind, placebo-controlled trial was conducted with 120 psychiatric inpatients receiving chronic antipsychotic therapy. Participants were allocated to: Intervention group: Conventional antipsychotics + Guanxinning tablets (0.38 g × 4 tablets, ter in die); Control group: Conventional antipsychotics + identical placebo; Cardiac assessments at baseline and 12 months included: Electrocardiography (corrected QT interval), echocardiography (left ventricular ejection fraction, left ventricular end-diastolic diameter), serum biomarkers (cardiac troponin I, B-type natriuretic peptide, superoxide dismutase, malondialdehyde, high-sensitivity C-reactive protein).

Results: Compared to controls, the Guanxinning group showed: Electrophysiological improvement: Corrected QT shortening (438 ± 25 milliseconds vs 465 ± 30 milliseconds, P < 0.01). Functional enhancement: Left ventricular ejection fraction increase (58.5% ± 5.2% vs 53.8% ± 4.8%, P < 0.05), left ventricular end-diastolic diameter reduction (49.8 ± 3.5 mm vs 52.6 ± 3.8 mm, P < 0.05), Biochemical modulation: Reduced myocardial injury markers (cardiac troponin I: 0.009 ng/mL vs 0.014 ng/mL; B-type natriuretic peptide: 52 pg/mL vs 78 pg/mL, P < 0.001), improved oxidative stress (superoxide dismutase: ↑13.3 U/mL; malondialdehyde: ↓0.9 nmol/mL, P < 0.001), attenuated inflammation (high-sensitivity C-reactive protein: 2.0 mg/L vs 3.2 mg/L, P < 0.001).

Conclusion: Guanxinning significantly mitigates antipsychotic-induced cardiac injury in psychiatric patients, demonstrating: Normalization of electrophysiological parameters, Preservation of systolic/diastolic function, suppression of oxidative stress and inflammation. These findings support its clinical application as an adjunctive cardioprotective therapy, potentially through inhibition of myocardial apoptosis and antioxidant upregulation.

Background: Knee osteoarthritis (KOA), a common disabling pathology characterized by knee joint pain, swelling, and functional impairment, primarily affects middle-aged and older adults. In addition to physical limitations, chronic pain often leads to psychological problems, including anxiety and depression, which further impact patients' quality of life.

Aim: To examine the efficacy and safety of celecoxib plus duloxetine in managing chronic pain, anxiety, and depression in patients with KOA.

Methods: A retrospective analysis was conducted on 123 patients with KOA treated at our center between February 2020 and February 2023. Of these, 66 received celecoxib plus duloxetine, and 57 received celecoxib alone. Outcomes were assessed using the Visual Analog Scale (VAS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Self-Rating Anxiety Scales (SAS)/Self-Rating Depression Scales (SDS). Safety was evaluated by monitoring changes in liver function enzymes (alanine aminotransferase, aspartate aminotransferase), creatinine, and blood urea nitrogen.

Results: Patients receiving celecoxib plus duloxetine showed significantly greater reductions in VAS and WOMAC and greater improvements in SAS and SDS scores compared with those receiving celecoxib alone. Hepatorenal function did not differ significantly between the treatment groups. Logistic regression analysis identified patient age, educational background, and treatment regimen as independent predictors of inadequate improvement in negative emotional symptoms.

Conclusion: In patients with KOA, celecoxib plus duloxetine effectively mitigates chronic pain and improves anxiety and depressive symptoms without increasing adverse hepatic or renal effects. These findings support its use as a safe and effective treatment option.

Common mental disorders (CMDs), such as depressive and anxiety disorders, constitute a significant public health problem in low- and middle-income countries, such as India, where they rank among the leading causes of disability and impaired quality of life. Outcomes are further compromised by a large treatment gap, poor adherence to therapeutic regimens, and high attrition rates. The prevalence and severity of CMDs are disproportionately higher in women. Additionally, structural factors influencing healthcare access, along with sociocultural factors, such as gender-based violence, limited autonomy in healthcare decisions, and greater levels of discrimination and stigma, result in poorer outcomes among women with CMDs. Therefore, there is a pressing need for care packages that are culturally sensitive, gender-responsive, and designed to address these structural and sociocultural factors, as highlighted in the literature from India.

Background: Preoperative anxiety is a significant concern for patients, as it affects surgical outcomes, satisfaction, and pain perception. Although both anxiety and pain are common in surgical settings, their relationship with personality traits has not been previously investigated in the Lebanese population.

Aim: To examine the prevalence of preoperative anxiety, pain perception, and personality traits among Lebanese surgical patients, and to assess the associations between these factors.

Methods: A descriptive cross-sectional study was conducted between April 2024 and January 2025 across Lebanese hospitals. A total of 392 adult patients were recruited through convenience sampling. Data were collected using a questionnaire that included sociodemographic, clinical, and surgical variables, the Amsterdam Preoperative Anxiety and Information Scale for anxiety, the Visual Analog Scale and Numerical Pain Rating Scale for preoperative pain, and the Ten-Item Personality Inventory for personality traits. Ethical approval was obtained from the Institutional Review Boards of Makassed General Hospital and Hammoud University Medical Center.

Results: Overall, 25% of participants experienced preoperative anxiety, and 34.5% reported moderate pain. Personality assessment showed that the majority of participants had moderate extraversion (84.1%), moderate emotional stability (65.1%), high conscientiousness (61%), high agreeableness (54.1%), and moderate openness (49.2%). High conscientiousness was significantly associated with higher pain perception (P < 0.05), while high emotional stability was associated with lower levels of anxiety (P < 0.05). No significant association was found between preoperative anxiety and pain (P > 0.05).

Conclusion: This study challenges the assumption that preoperative anxiety and pain are directly correlated and highlights the role of personality traits in shaping patient experience. These findings support the potential value of integrating psychological profiling into preoperative care and lay the groundwork for developing personalized interventions to improve patient-centered surgical outcomes.

Background: Dry eye disease (DED) is a multifactorial ocular surface disorder with rising prevalence. It is closely related to systemic health and psychological factors, such as sleep and mood disorders, which significantly impact the quality of life of patients.

Aim: To explore the correlations between ocular surface function, sleep quality, and anxiety/depression in patients with DED.

Methods: This was a cross-sectional investigative study that included 358 patients with DED between January 2022 and January 2025. Ocular surface was assessed using the ocular surface disease index (OSDI), tear film break-up time, fluorescein staining score, and Schirmer I test. The Pittsburgh Sleep Quality Index (PSQI), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) were used to evaluate sleep quality and anxiety/depression levels. Correlation and linear regression analyses were used to explore the relationships.

Results: The mean PSQI score of the patients was 9.94 ± 2.18; the mean SAS score was 47.30 ± 4.90, and the mean SDS score was 50.08 ± 5.52. These suggested a prevalence of sleep and psychological abnormalities. There was a significant correlation between the indicators of ocular surface function (OSDI, tear film break-up time, fluorescein staining, and Schirmer I test) and PSQI, SAS, and SDS scores (P < 0.05). Moreover, multiple regression revealed that age ≥ 50 years (β = 1.55, P = 0.029), PSQI scores (β = 0.58, P < 0.001), SAS scores (β = 0.17, P = 0.017), and SDS scores (β = 0.15, P = 0.019) were independent predictors of the OSDI scores.

Conclusion: Ocular surface function in patients with DED is closely related to sleep quality and anxiety/depression, emphasizing the need for holistic clinical management.

Non-right-handedness (NRH), encompassing left-handedness and mixed-handedness, has been frequently reported at elevated rates in individuals with various psychiatric disorders. The consistency of this association across multiple conditions and its underlying mechanisms is the subject of ongoing investigation. This review synthesized current evidence to explore the association between NRH and psychiatric disorders from epidemiological, genetic, and neurobiological perspectives. We systematically identified and appraised relevant literature investigating NRH prevalence in psychiatric populations and potential explanatory mechanisms. Epidemiological evidence indicates an elevated prevalence of NRH, particularly within neurodevelopmental disorders. Potential contributing mechanisms identified include early developmental disruptions, shared genetic predispositions, and atypical patterns of brain lateralization. While the association between NRH and psychiatric conditions, especially neurodevelopmental disorders, is evident, the causal pathways and relative contributions of identified mechanisms are complex and debated. This review highlighted key areas requiring further research to elucidate these relationships.

Background: Digestive tract subepithelial lesions (SELs) are relatively common, and early diagnosis and treatment are critical for improving patient quality of life and prognosis. However, diagnostic uncertainty often leads to negative psychological effects, including anxiety and depression.

Aim: To investigate the prevalence of anxiety and depressive symptoms and identify associated factors among patients with digestive tract SELs.

Methods: This retrospective study included 296 consecutive patients diagnosed with digestive tract SELs at the Affiliated Hospital of North Sichuan Medical College Endoscopy Center between October 2024 and April 2025. Demographic and clinical data were collected through standardized questionnaires. Anxiety and depression were assessed using the Self-Rating Anxiety Scale and the Self-Rating Depression Scale, respectively, while sleep quality was evaluated using the Pittsburgh Sleep Quality Index. Participants were classified into anxiety vs non-anxiety and depression vs non-depression groups based on established cutoff scores, and potential determinants were examined.

Results: Anxiety symptoms were observed in 35.8% of cases (mean Self-Rating Anxiety Scale score: 46.56 ± 9.13) and depressive symptoms in 33.1% (mean Self-Rating Depression scale score: 48.64 ± 8.30). Pittsburgh Sleep Quality Index scores were positively correlated with both anxiety and depression (P < 0.05). Univariate analysis identified age, annual income, sleep disorders, and endoscopic ultrasonography (EUS) evaluation status as significant factors (P < 0.05). Multivariable analysis revealed that low annual income (< 10000 Chinese yuan) and sleep disorders were independent risk factors, whereas undergoing EUS examination and having disease awareness were protective factors against anxiety and depression (P < 0.05).

Conclusion: Patients with digestive tract SELs are at increased risk for anxiety and depression, with poor sleep strongly linked to worsening psychological symptoms. Early diagnostic assessment with EUS appears to serve a protective role against the onset of these psychological disorders.