World Journal of Psychiatry最新文献

Sleep is a critical yet often underestimated physiological parameter in psychiatric disorders. In their article, Gokcay et al examined sleep quality in bipolar disorder patients treated with lithium or valproic acid, showing lithium's advantage in habitual sleep efficiency and reduced disturbances. While this study provides valuable data in a chronic and clinically challenging cohort, reliance solely on self-reported sleep measures remains a limitation. Polysomnography, although the gold standard, is not always practical; therefore, actigraphy and wearable technologies represent feasible alternatives to capture objective sleep patterns. This letter emphasizes the importance of integrating objective, scalable technologies and pharmacological monitoring into longitudinal designs to clarify whether improvements in sleep translate into better clinical outcomes and reduced relapse risk in bipolar disorder.

Background: Breast cancer is one of the most common cancers among women worldwide, often leading to significant emotional and psychological stress. This stress is compounded by concerns about parenting roles and the potential impact on children. Mindfulness-based cognitive therapy (MBCT) has shown promise in addressing anxiety and depressive symptoms. However, its effects on parenting anxiety and self-efficacy in patients with breast cancer are underexplored.

Aim: To evaluate the effects of MBCT on parenting anxiety, negative emotions, quality of life (QoL), and self-efficacy in patients with breast cancer.

Methods: This retrospective study involved 249 patients with breast cancer admitted between January 2024 and December 2024. Participants were divided into two groups: The conventional treatment group (n = 123) and the MBCT group (n = 126), based on chosen treatment methods. Interventions lasted 8 weeks, with one session per week. Outcomes were measured using standardized questionnaires, including parenting anxiety [parenting concerns questionnaire (PCQ)], parenting sense of competence [parenting sense of competence scale (PSOCS)], negative emotions (self-rating anxiety scale and self-rating depression scale), hospital anxiety and depression [hospital anxiety and depression scale (HADS)], trauma-related distress [impact of event scale-revised (IES-R)], mindfulness (five-facet mindfulness questionnaire), QoL [functional assessment of cancer therapy-breast (FACT-B)], symptom severity (numeric rating scales), and self-efficacy [general self-efficacy scale (GSES)].

Results: Post-treatment, the MBCT group showed a marked reduction in parenting anxiety scores (PCQ: MBCT 50.54 ± 4.65 vs conventional 52.12 ± 5.53, P = 0.016) and notable improvement in parenting competence (PSOCS total: MBCT 61.56 ± 4.65 vs conventional 59.75 ± 4.96, P = 0.003). The MBCT group also exhibited significant reductions in anxiety (HADS anxiety: MBCT 6.78 ± 1.65 vs conventional 7.31 ± 2.08, P = 0.027) and trauma-related distress (IES-R intrusion: P = 0.030; avoidance: P = 0.004; hyperarousal: P = 0.035). QoL scores significantly improved in the MBCT group in terms of physiological condition (FACT-B: MBCT 13.85 ± 3.93 vs conventional 12.55 ± 2.75, P = 0.003) and functional status (P = 0.010). Enhanced self-efficacy was observed in strategic effectiveness (GSES: MBCT 9.87 ± 0.75 vs conventional 9.72 ± 0.13, P = 0.029).

Conclusion: MBCT significantly reduces parenting anxiety and enhances self-efficacy, QoL, and emotional regulation in patients with breast cancer.

Background: Postpartum hemorrhoids are common complications in women after childbirth, with an incidence rate of 37.9%. Progesterone levels increase during pregnancy, which can lead to constipation. Abdominal pressure surges sharply during delivery, which can block the venous return of the rectum and result in hemorrhoids, pain, and edema. Tongyangxiao lotion and Ziyu ointment, traditional Chinese medicinal preparations, have the efficacy of subduing swelling, relieving itching, and promoting healing; however, their combined application in treating postpartum hemorrhoids is less studied.

Aim: To investigate effects of Tongyangxiao lotion sitz bath therapy combined with Ziyu ointment on postpartum hemorrhoidal pain, edema, anxiety, and depression.

Methods: A retrospective analysis was conducted at Hebei Hospital of Traditional Chinese Medicine on 268 patients with hemorrhoids (September 2023 to February 2025). They were divided according to treatment method into control (wet compress with magnesium sulfate + Ziyu ointment) and observation (Tongyangxiao lotion sitz bath therapy + Ziyu ointment) groups (n = 134 in each group). Degree of pain, comfort level, compliance behavior with medical care, psychological state, therapeutic effect, hemorrhoid edema score, incidence of adverse reactions, and hemorrhoid diameter were compared.

Results: No statistically significant difference was observed in the diameter of the hemorrhoids or edema between the two groups before treatment. Hemorrhoid diameter and degree of edema were significantly smaller in the observation group than those in the control group 14 days post treatment. No statistically significant difference was observed in the scores of the General Comfort Questionnaire (GCQ) dimensions and participants' compliance before treatment. All GCQ dimension scores were significantly higher in the observation group than those in the control group 7 and 14 days post treatment. The compliance rate was significantly higher in the observation group than that of the control group. No statistically significant difference was observed in the incidence of adverse reactions between the two groups (P > 0.05).

Conclusion: Tongyangxiao lotion combined with Ziyu ointment can improve patients' surface edema, postpartum hemorrhoid pain, treatment adherence, and comfort, reducing negative emotions. This is relatively safe and worthy of clinical promotion.

In this editorial, I comment on the article conducted by Yang and Woo. Mental health in older adults remains underserved and underexamined, with final decades shaped by cumulative life stressors, chronic conditions, and social determinants that disproportionately affect marginalized communities. In this study, I would like to synthesize current evidence on the prevalence, presentation, and trajectories of mental health concerns among older adults, highlighting common challenges such as late-life depression, anxiety, cognitive concerns, and underutilization of care. I am going to examine barriers to outreach and treatment, including stigma, cultural and linguistic mismatches, access limitations, and gaps in geriatric mental health services. The analysis in the paper identifies promising pathways to improve outcomes: Community-engaged interventions, culturally tailored care models, integration of mental health with primary and geriatric care, and policy reforms to expand coverage and reduce disparities. As a conclusion, with actionable recommendations for clinicians, researchers, policymakers, and community organizations to break the silence, enhance early detection, and foster resilient aging through equitable, person-centered approaches.

Background: The coexistence of rheumatological and immunological diseases with nephropathy presents considerable clinical challenges. These challenges often result in heightened anxiety and depression, which detrimentally affect patient outcomes. Motivational psychological nursing, which incorporates motivational interview and cognitive-behavioral therapy, may offer a promising approach to address these psychological concerns.

Aim: To evaluate the effectiveness of motivational psychological nursing in the reduction of anxiety and depression and improvement of the quality of life of patients with rheumatological and immunological diseases complicated by nephropathy.

Methods: We conducted a retrospective cohort study involving 206 patients with rheumatological and immunological diseases complicated by nephropathy and who were treated between January 2021 and January 2025. The inclusion criteria were as follows: Aged 18-75 years, met the diagnostic criteria for rheumatological and immunological diseases with a renal biopsy classification above type II, hospitalized in our facility, received consistent basic nursing care, and had complete clinical data available. Participants allotted to the observation group (n = 102) receiving motivational psychological nursing, and those in the control group (n = 104) received standard care. Psychological status was assessed using Self-Rating Anxiety Scale (SAS), Beck Anxiety Inventory, Hamilton Anxiety Rating Scale, Self-Rating Depression Scale (SDS), Patient Health Questionnaire-9, and other standardized measures. Intervention lasted throughout hospitalization, with follow-up assessments conducted before discharge.

Results: Pre-intervention, anxiety, and depression scores were similar across groups. Postintervention, the observation group showed significant reductions in anxiety (SAS: 44.53 ± 6.72 vs 46.79 ± 6.94; P = 0.018) and depression (SDS: 45.20 ± 5.07 vs 46.97 ± 5.25; P = 0.014) compared with the control group. General self-efficacy (P = 0.044), health-related quality of life (P = 0.044), and World Health Organization Quality of Life (P = 0.040) scores also revealed significant improvement.

Conclusion: Motivational psychological nursing considerably reduces anxiety and depression in patients with rheumatological and immunological diseases complicated by nephropathy, which enhances the overall quality of life.

Background: Cervical cancer, a prevalent gynecological malignancy, exhibits recurrence rates of 30%-50% post-treatment, with recurrent cases facing a dire 10%-20% long-term survival rate, severely impacting patients' mental health and quality of life. Fear of cancer recurrence (FCR) emerges as a critical psychological challenge, often leading to anxiety, social avoidance, and even suicidal tendencies. Despite its high prevalence, structured, evidence-based interventions for FCR in cervical cancer remain scarce, with most studies focusing on general psychological support rather than targeted strategies. The fear of progression theory provides a theoretical framework, highlighting cognitive-emotional conflicts arising from perceived threats of disease recurrence. Addressing this gap, this study developed a specialized, phased psychological intervention program grounded in fear of progression theory, aiming to reduce FCR and enhance resilience in cervical cancer survivors through multi-disciplinary strategies.

Aim: To establish a psychological intervention program to support the fear of cervical cancer recurrence and to alleviate the psychological pressure of patients after cervical cancer surgery.

Methods: Thirteen experts were selected to conduct two rounds of correspondence through literature review and group discussions to amend the psychological intervention draft and form the basis for the psychological intervention. The selected experts also performed two rounds of correspondence to revise the psychological intervention draft and outline the first draft, and pre-experiments were conducted for further improvement of the psychological intervention program. Experiments were performed in 80 patients with cervical cancer to further improve the psychological intervention program of relapse fear support.

Results: The expert authority coefficient of the first and second rounds was higher than 0.8, indicating high authority. The coordination coefficient > 0.8 indicated high consistency with high significance (all P < 0.05). The FCR Inventory, Kessler Psychological Distress Scale, Psychological Distress Thermometer, and General Hospital Anxiety and Depression Scale scores at 3 and 6 months in the study group were lower than those of the control group, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and Perceived Social Support Scale scores were higher than those of the control group (P < 0.05).

Conclusion: The psychological intervention program of relapse fear support which considers the individual differences between patients and expert opinions, has a good scientific and practical basis, and can be used to enhance the quality of life of patients.

Background: Prostate cancer is common among men, and radical surgery is the primary treatment. Surgery, however, can affect both physical and mental health, including anxiety, depression, and quality of life (QoL).

Aim: To assess the effect of radical prostatectomy on psychological status and QoL in patients with prostate cancer.

Methods: This observational study included 102 patients undergoing radical prostatectomy between June 2024 and April 2025. Pain (numerical rating scale), Hamilton Anxiety Scale, Hamilton Depression Scale, and QoL (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and short-form 36) were evaluated before and after surgery.

Results: At one month postoperatively, the mean European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 score increased significantly from 60.72 ± 5.37 preoperatively to 86.48 ± 7.52 (P < 0.001), indicating marked improvement in overall QoL. Psychological assessments revealed significant reductions in anxiety and depression: The mean Hamilton Anxiety Scale score decreased from 23.36 ± 5.15 preoperatively to 12.15 ± 4.36 (P < 0.001), and the mean Hamilton Depression Scale score declined from 22.61 ± 5.02 to 13.83 ± 4.54 (P < 0.001). Pain levels, as measured by the numerical rating scale, decreased significantly from 7.68 ± 2.17 preoperatively to 2.67 ± 0.72 (P < 0.001). Additionally, the urinary incontinence rate dropped from 20.59% (21/102) preoperatively to 11.76% (12/102) (P < 0.05), showing a statistically significant reduction.

Conclusion: Radical prostatectomy improves psychological health and the QoL of patients with prostate cancer. These results may help to inform future therapies.

Background: Proper antidepressant use can improve mood and reduce desire to drink alcohol in alcohol-induced-affective-disorder patients. Shugan Jieyu capsules (SJC) have various impacts on the central nervous system, producing antidepressant effects. Traditional Chinese medicine (including Shugan Jieyu) is highly therapeutic in treating alcohol dependence, with few side-effects. However, research on its combination with Western antidepressants (e.g., sertraline) to improve patients' depression is insufficient.

Aim: To evaluate the clinical efficacy and safety of SJC combined with sertraline vs sertraline monotherapy in alcohol-dependent patients with comorbid depression.

Methods: We conducted a randomized, double-blind, placebo-controlled trial. Sixty patients (aged 18-65 years) were randomly assigned to two groups (n = 30 per group). Primary outcome: Hamilton Depression Rating Scale (HAMD)-17 changes over 6 weeks. Benzodiazepines were permitted for severe insomnia.

Results: The HAMD-17 score of the study (vs control) group was lower at treatment weeks 2, 4, and 6 (P < 0.05). Regarding intra-group comparisons, the study group's HAMD score was significantly lower than that before treatment from week 2 (P < 0.05), while that of the control group was significantly lower than that before treatment from week 4 (P < 0.05). The study and control groups' total efficacy rates were 90% and 73.3%, respectively, showing a significant difference in efficacy (χ² = 4.812, P = 0.028). No significant difference was observed in adverse reactions' incidence between the groups at treatment weeks 2, 4, and 6 (P > 0.05).

Conclusion: SJC-sertraline combination therapy accelerates depressive symptom relief (by 2 weeks) and improves response rates (+16.7%) in alcohol-dependent patients, without increasing adverse events. Clinical outcomes suggest potential synergistic mechanisms, though no biomarker analyses were performed.

Background: Pelvic organ prolapse (POP) can lead to urinary incontinence, fecal incontinence, and other symptoms, affecting the quality of life, which results in anxiety and depression and other negative emotions in many patients. Trans-vaginal sacrospinous ligament suspension (VSSLS) involves securing the apex of the prolapsed vagina to the sacrospinous ligament to maintain the physiological axis of the vagina, help in repairing pelvic floor defects, and maintain the normal function of the pelvic floor, thereby alleviating patients' anxiety and depression.

Aim: To explore the effect of VSSLS in the treatment of POP and its influence on anxiety and depression among patients.

Methods: Sixty patients with moderate to severe POP who underwent surgical treatment between January 2023 and June 2024 in Suzhou Ninth Hospital Affiliated to Soochow University were retrospectively enrolled in the study. According to treatment methods, they were divided into the control group (n = 30, treated with vaginal hysterectomy alone) and observation group (n = 30, treated with VSSLS combined with vaginal hysterectomy). The two groups were compared by baseline data, perioperative indicators, and postoperative pain intensity, prolapse distance before and after surgery, sexual function, pelvic function, anxiety, and depression.

Results: No significant differences in baseline data, preoperative POP Quantification measurement value, Pelvic Floor Dysfunction Inventory 20 (PFDI-20), Pelvic Floor Impact Questionnaire 7 (PFIQ-7), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) scores were found between the two groups. The observation group had longer operation time and more intraoperative blood loss than the control group, the Visual Analog Scale score on postoperative day 1 was slightly higher in than in the control group. On the reexamination 3 months postoperatively, the POP Quantification measurement values in the observation group were lower than those in the control group (P < 0.05). Evaluation 6 months after surgery, the FSFI score was higher in the observation group than in the control group, the PFDI-20, PFIQ-7, SAS and SDS score scored were lower in than in the control group (P < 0.05). The PFDI-20, PFIQ-7 scores positively correlated with the SAS and SDS scores.

Conclusion: VSSLS demonstrated a significant effect on the treatment of moderate and severe POP, as it can reduce the prolapse distance and PFDI-20 and PFIQ-7 scores and improve anxiety and depression among patients.