World Journal of Psychiatry最新文献

Background: Revisiting the epidemiology of posttraumatic stress symptoms (PTSSs) among university students during the coronavirus disease 2019 (COVID-19) pandemic as well as understanding the mental health help-seeking behavior of individuals with PTSSs has critical implications for public mental health strategies in future medical pandemics.

Aim: To investigate the prevalence and correlates of PTSSs among university students during the first wave of the COVID-19 pandemic in China and to examine mental health help-seeking behaviors among these students.

Methods: A total of 2507 Chinese university students were recruited via snowball sampling. The students completed the Seven-item Screening Scale for Post-traumatic Stress Disorder during the first wave of the COVID-19 pandemic in China. Sociodemographic characteristics, pandemic-related characteristics, and mental health help-seeking behaviors of students with PTSSs were also collected.

Results: The prevalence of PTSSs among the participants was 28.0%. Seven significant correlates of PTSSs were identified (odds ratio = 1.23-3.65, P ≤ 0.024): Female sex, being 19 years old or older, living with others or alone, a low level of family economic status, fair or poor interpersonal relationships, severe or very severe local pandemic, and having family members diagnosed with COVID-19. However, only 3.28% of the students with PTSSs reported seeking help from mental health specialists. Among the 23 students who sought help from mental health specialists, 13 opted for online or telephone-based psychological consultation.

Conclusion: Our data suggest that there was a high risk of PTSSs among university students and a high level of unmet mental health needs during the COVID-19 pandemic. The delivery of mental health services online or via telephone is a promising approach to address these unmet needs.

In this editorial, I comment on the article by Zhang et al. To emphasize the importance of the topic, I discuss the relationship between the use of smart medical devices and mental health. Smart medical services have the potential to positively influence mental health by providing monitoring, insights, and interventions. However, they also come with challenges that need to be addressed. Understanding the primary purpose for which individuals use these smart technologies is essential to tailoring them to specific mental health needs and preferences.

A recent study by Wang et al, published in the World Journal of Psychiatry, provided preventative and therapeutic strategies for the comorbidity of obesity and depression. The gut-brain axis, which acts as a two-way communication system between the gastrointestinal tract and the central nervous system, plays a pivotal role in the pathogenesis of these conditions. Evidence suggests that metabolic byproducts, such as short-chain fatty acids, lipopolysaccharide and bile acids, which are generated by the gut microbiota, along with neurotransmitters and inflammatory mediators within the gut-brain axis, modulate the host's metabolic processes, neuronal regulation, and immune responses through diverse mechanisms. The interaction between obesity and depression via the gut-brain axis involves disruptions in the gut microbiota balance, inflammatory immune responses, and alterations in the neuroendocrine system. Modulating the gut-brain axis, for example, through a ketogenic diet, the use of probiotics, and the supplementation of antioxidants, offers new remedial approaches for obesity and depression. Future research that explores the mechanisms of the gut-brain axis is needed to provide more evidence for clinical treatment.

Background: The imbalance of hormone levels in the body is closely related to the occurrence and progression of schizophrenia, especially thyroid hormones.

Aim: To study the relationship between triiodothyronine (T3), thyroxine (T4), free T3 (FT3), free T4 (FT4), thyroid stimulating hormone (TSH) and schizophrenia.

Methods: In this study, 100 schizophrenia patients were selected from our hospital between April 2022 and April 2024. Their clinical data were analyzed retrospectively. Based on the Positive and Negative Syndrome Scale (PANSS) score, patients were divided into mild (1-3 points, n = 39), moderate (4 points, n = 45), and severe groups (5-7 points, n = 16). Additionally, 55 healthy individuals served as a control group. Venous blood samples were collected to measure T3, T4, FT3, FT4, TSH, and cortisol concentrations, analyzing their relationship with PANSS scores.

Results: The serum levels of T3, FT3, FT4, TSH and cortisol in the schizophrenia group were lower than those in the control group (P < 0.05). With the increase of the severity of the disease, the concentrations of T3 and T4 decreased, while the concentrations of TSH and cortisol increased (P < 0.05). The concentrations of TSH and cortisol were positively correlated with the PANSS score, while T3 and T4 were negatively correlated with the PANSS score (P < 0.05). The receiver operating characteristic curve results showed that T3, T4, TSH, and cortisol had good efficacy in the diagnosis of schizophrenia. Logistic results showed that decreased T3 level, decreased T4 level, decreased TSH level and increased cortisol level may be independent risk factors for schizophrenia.

Conclusion: Thyroid hormone levels are associated with the severity of schizophrenia symptoms, which can provide new solutions for the diagnosis and treatment of schizophrenia.

This letter provides a concise review of the pertinent literature on visual and tactile hallucinations in elderly patients. The discussion addresses differential diagnoses and potential underlying mechanisms, as well as the psychopathology associated with tactile hallucinations, and emphasizes the necessity for investigation into the possibility of coexisting delusional infestation (parasitosis). These symptoms frequently manifest in patients with primary psychotic disorders, organic mental disorders, and substance use disorders. The proposed pathophysiological mechanisms may involve dopaminergic imbalances and dysfunction of the striatal dopamine transporter.

Background: The use of network pharmacology and blood metabolomics to study the pathogenesis of violent aggression in patients with schizophrenia and the related drug mechanisms of action provides new directions for reducing the risk of violent aggression and optimizing treatment plans.

Aim: To explore the metabolic regulatory mechanism of olanzapine in treating patients with schizophrenia with a moderate to high risk of violent aggression.

Methods: Metabolomic technology was used to screen differentially abundant metabolites in patients with schizophrenia with a moderate to high risk of violent aggression before and after olanzapine treatment, and the related metabolic pathways were identified. Network pharmacology was used to establish protein-protein interaction networks of the core targets of olanzapine. Gene Ontology functional analysis and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis were subsequently performed.

Results: Compared with the healthy group, the patients with schizophrenia group presented significant changes in the levels of 24 metabolites related to the disruption of 9 metabolic pathways, among which the key pathways were the alanine, aspartate and glutamate metabolism and arginine biosynthesis pathways. After treatment with olanzapine, the levels of 10 differentially abundant metabolites were significantly reversed in patients with schizophrenia. Olanzapine effectively regulated six metabolic pathways, among which the key pathways were alanine, aspartate and glutamate metabolism and arginine biosynthesis pathways. Ten core targets of olanzapine were involved in several key pathways.

Conclusion: The metabolic pathways of alanine, aspartate, and glutamate metabolism and arginine biosynthesis are the key pathways involved in olanzapine treatment for aggressive schizophrenia.

Background: At present, the influencing factors of social function in patients with residual depressive symptoms are still unclear. Residual depressive symptoms are highly harmful, leading to low mood in patients, affecting work and interpersonal communication, increasing the risk of recurrence, and adding to the burden on families. Studying the influencing factors of their social function is of great significance.

Aim: To explore the social function score and its influencing factors in patients with residual depressive symptoms.

Methods: This observational study surveyed patients with residual depressive symptoms (case group) and healthy patients undergoing physical examinations (control group). Participants were admitted between January 2022 and December 2023. Social functioning was assessed using the Sheehan Disability Scale (SDS), and scores were compared between groups. Factors influencing SDS scores in patients with residual depressive symptoms were analyzed by applying multiple linear regression while using the receiver operating characteristic curve, and these factors' predictive efficacy on social function impairment was assessed.

Results: The SDS scores of the 158 patients with depressive symptoms were 11.48 ± 3.26. Compared with the control group, the SDS scores and all items in the case group were higher. SDS scores were higher in patients with relapse, discontinuous medication, drug therapy alone, severe somatic symptoms, obvious residual symptoms, and anxiety scores ≥ 8. Disease history, medication compliance, therapy method, and residual symptoms correlated positively with SDS scores (r = 0.354, 0.414, 0.602, and 0.456, respectively). Independent influencing factors included disease history, medication compliance, therapy method, somatic symptoms, residual symptoms, and anxiety scores (P < 0.05). The areas under the curve for predicting social functional impairment using these factors were 0.713, 0.559, 0.684, 0.729, 0.668, and 0.628, respectively, with sensitivities of 79.2%, 61.8%, 76.8%, 81.7%, 63.6%, and 65.5% and specificities of 83.3%, 87.5%, 82.6%, 83.3%, 86.7%, and 92.1%, respectively.

Conclusion: The social function scores of patients with residual symptoms of depression are high. They are affected by disease history, medication compliance, therapy method, degree of somatic symptoms, residual symptoms, and anxiety.

Background: Emotional reactions, such as anxiety, irritability, and aggressive behavior, have attracted clinical attention as behavioral and emotional problems in preschool-age children.

Aim: To investigate the current status of family rearing, parental stress, and behavioral and emotional problems of preschool children and to analyze the mediating effect of the current status of family rearing on parental stress and behavioral/emotional problems.

Methods: We use convenience sampling to select 258 preschool children in the physical examination center of our hospital from October 2021 to September 2023. The children and their parents were evaluated using a questionnaire survey. Pearson's correlation was used to analyze the correlation between child behavioral and emotional problems and parental stress and family rearing, and the structural equation model was constructed to test the mediating effect.

Results: The score for behavioral/emotional problems of 258 preschool children was (27.54 ± 3.63), the score for parental stress was (87.64 ± 11.34), and the score for parental family rearing was (31.54 ± 5.24). There was a positive correlation between the behavioral and emotional problems of the children and the "hostile/mandatory" parenting style; meanwhile, showed a negative correlation with the "support/ participation" parenting style (all P < 0.05). The intermediary effect value between the family upbringing of parents in parental stress and children's behavior problems was 29.89%.

Conclusion: Parental family upbringing has a mediating effect between parental stress and behavioral and emotional problems of children. Despite paying attention to the behavioral and emotional problems of preschool-age children, clinical medical staff should provide correct and reasonable parenting advice to their parents to promote the mental health of preschool-age children.

Background: Mild cognitive impairment (MCI) has a high risk of progression to Alzheimer's disease. The disease is often accompanied by sleep disorders, and whether sleep disorders have an effect on brain function in patients with MCI is unclear.

Aim: To explore the near-infrared brain function characteristics of MCI with sleep disorders.

Methods: A total of 120 patients with MCI (MCI group) and 50 healthy subjects (control group) were selected. All subjects underwent the functional near-infrared spectroscopy test. Collect baseline data, Mini-Mental State Examination, Montreal Cognitive Assessment scale, fatigue severity scale (FSS) score, sleep parameter, and oxyhemoglobin (Oxy-Hb) concentration and peak time of functional near-infrared spectroscopy test during the task period. The relationship between Oxy-Hb concentration and related indexes was analyzed by Pearson or Spearmen correlation.

Results: Compared with the control group, the FSS score of the MCI group was higher (t = 11.310), and the scores of Pittsburgh sleep quality index, sleep time, sleep efficiency, nocturnal sleep disturbance, and daytime dysfunction were higher (Z = -10.518, -10.368, -9.035, -10.661, -10.088). Subjective sleep quality and total sleep time scores were lower (Z = -11.592, -9.924). The sleep efficiency of the MCI group was lower, and the awakening frequency, rem sleep latency period, total sleep time, and oxygen desaturation index were higher (t = 5.969, 5.829, 2.887, 3.003, 5.937). The Oxy-Hb concentration at T0, T1, and T2 in the MCI group was lower (t = 14.940, 11.280, 5.721), and the peak time was higher (t = 18.800, 13.350, 9.827). In MCI patients, the concentration of Oxy-Hb during T0 was negatively correlated with the scores of Pittsburgh sleep quality index, sleep time, total sleep time, and sleep efficiency (r = -0.611, -0.388, -0.563, -0.356). It was positively correlated with sleep efficiency and total sleep time (r = 0.754, 0.650), and negatively correlated with oxygen desaturation index (r = -0.561) and FSS score (r = -0.526). All comparisons were P < 0.05.

Conclusion: Patients with MCI and sleep disorders have lower near-infrared brain function than normal people, which is related to sleep quality. Clinically, a comprehensive assessment of the near-infrared brain function of patients should be carried out to guide targeted treatment and improve curative effect.

There is growing evidence that interleukin (IL)-6 plays an important role in neurological and psychiatric disorders. This editorial comments on the study published in the recent issue of the World Journal of Psychiatry, which employed Mendelian randomization to identify a causal relationship between IL-6 receptor blockade and decreased epilepsy incidence. The purpose of this editorial is to highlight the dual effects of IL-6 in epilepsy and its related neuropsychiatric comorbidities. IL-6 plays a critical role in the facilitation of epileptogenesis and maintenance of epileptic seizures and is implicated in neuroinflammatory processes associated with epilepsy. Furthermore, IL-6 significantly influences mood regulation and cognitive dysfunction in patients with epilepsy, highlighting its involvement in neuropsychiatric comorbidities. In summary, IL-6 is not only a pivotal factor in the pathogenesis of epilepsy but also significantly contributes to the emergence of epilepsy-related neuropsychiatric complications. Future research should prioritize elucidating the specific mechanisms by which IL-6 operates across different subtypes, stages and neuropsychiatric comorbidities of epilepsy, with the aim of developing more precise and effective interventions. Furthermore, the potential of IL-6 as a biomarker for the early diagnosis and prognosis of epilepsy warrants further investigation.