World Journal of Psychiatry最新文献

Background: Anxiety and depression are highly prevalent among patients with cervical cancer (CC). However, few studies have systematically analyzed the psychological effects of tumor stage, treatment methods, and related factors on these patients, or developed predictive models for these outcomes.

Aim: To identify factors influencing anxiety and depression in patients with CC and construct predictive models.

Methods: We retrospectively analyzed data from 119 patients with CC treated at the Gynecology Department of Suzhou Ninth People's Hospital between January 2017 and May 2025. Clinical data, psychological hope levels at diagnosis, and Self-Rating Anxiety Scale and Self-Rating Depression Scale scores during treatment were collected. Influencing factors were identified, and predictive models were developed. The model performance was evaluated using receiver operating characteristic (ROC) curves and the Hosmer-Lemeshow goodness-of-fit test.

Results: During treatment, 64.71% of the patients experienced anxiety and 52.10% experienced depression. Significant differences in family income, tumor stage, treatment modality, and hope level were observed between patients with and without anxiety/depression (P < 0.05). Multivariate analysis showed that a family monthly income < 5000 yuan, stage III-IV tumor, comprehensive treatment, and low hope level were independent risk factors (P < 0.05). The predictive formula for anxiety was as follows: Logit (P) = 0.795 × monthly income + 0.594 × tumor stage + 1.095 × treatment method + 1.184 × hope level - 9.176; for depression: Logit (P) = 0.432 × monthly income + 0.518 × tumor stage + 0.727 × treatment method + 1.095 × hope level - 8.541. The area under the ROC curves were 0.865 for anxiety and 0.837 for depression. Goodness-of-fit test confirmed no overfitting (P > 0.05).

Conclusion: Family income, tumor stage, treatment method, and hope level are key determinants of anxiety and depression in patients with CC. Predictive models incorporating these factors can effectively assess risk of anxiety and depression during treatment.

Background: The neurological and psychiatric sequelae of coronavirus disease 2019 (COVID-19) have been documented, yet further data are needed to thoroughly evaluate the impact of COVID-19 on brain health years after the infection.

Aim: To examine whether COVID-19 infection is associated with exacerbation, recurrence, or progression of pre-existing neurological or psychiatric disorders - a high-risk population that is underrepresented in COVID-19 outcome research in National Guard Health Affair patients in 4-years following a COVID-19 diagnosis.

Methods: For this multicenter retrospective cohort study, we used data from the National Guard hospitals electronic health records network (BestCare) with over 10 million patients. Our cohort comprised patients who had a COVID-19 diagnosis; a matched control cohort included patient did not expose to COVID-19 in same period. Age and sex were matching factors. We estimated the incidence of 14 neurological and psychiatric outcomes in nearly 4 years after a confirmed diagnosis of COVID-19. Using a multiple logistic regression, we compared incidences with those in propensity score-matched cohorts of patients with no exposure to COVID-19.

Results: Our primary cohort comprised 4437 patients diagnosed with COVID-19, and our propensity-score 1:1 matched control cohort comprised 4437 individuals. Nearly two-third of the COVID-19 cohort (71%) were diagnosed in 2020, and 2021. The most prevalent diagnoses for both cohorts were epilepsy 30.68%, mood disorder 23.92%, and nerve plexus disorder 22.13%. Dementia was nearly 4 times higher among COVID-19 cohort (8.27%) compared to the control cohort (2.57%). Five neurological and psychiatric outcomes had odds ratios (OR) that were significantly higher than 1 for people who had COVID-19 compared to people who had never been infected. These outcomes were cognitive deficit OR = 1.54, 95% confidence interval (CI): 1.23-1.91, P = 0.0001; nerve plexus disorder OR = 1.13, 95%CI: 1.01-1.25, P = 0.02; substance use disorder OR = 1.95, 95%CI: 1.12-3.38, P = 0.01; mood disorder OR = 1.16, 95%CI: 1.05-1.29, P = 0.003; and anxiety disorder OR = 1.39, 95%CI: 1.07-1.79, P = 0.01.

Conclusion: The study highlights the persistent risk of neurological and psychiatric conditions in COVID-19 survivors up to four years post-infection. Although the incidence was lower than in previous large studies, long-term consequences remain significant, emphasizing the need for ongoing monitoring and support in mental health and neurological care.

Background: Patients with major depression (MD) exhibit conditional reasoning dysfunction; however, no studies on the event-related potential (ERP) characteristics of conditional reasoning in MD have been reported.

Aim: To investigate the ERP characteristics of conditional reasoning in MD patients and explore the neural mechanism of cognitive processing.

Methods: Thirty-four patients with MD and 34 healthy controls (HCs) completed ERP measurements while performing the Wason selection task (WST). The cluster-based permutation test in FieldTrip was used to compare the differences in the mean amplitudes between the patients with MD and HCs on the ERP components under different experimental conditions. Behavioral data [accuracy (ACC) and reaction times (RTs)], the ERP P100 and late positive potentials (LPPs) were analyzed.

Results: Although the mean ACC was greater and the mean of RTs was shorter in HCs than in MD patients, the differences were not statistically significant. However, across both groups, the ACC in the precautionary WST was greater than that in the other tasks, and the RTs in the abstract task were greater than those in the other tasks. Importantly, compared with that of HCs, the P100 of the left centroparietal sites was significantly increased, and the early LPP was attenuated at parietal sites and increased at left frontocentral sites; the medium LPP and late LPP were increased at the left frontocentral sites.

Conclusion: Patients with MD have conditional reasoning dysfunction and exhibit abnormal ERP characteristics evoked by the WST, which suggests neural correlates of abnormalities in conditional reasoning function in MD patients.

Background: Ovarian cancer patients often face complex treatment processes and psychological challenges, with different treatment modalities potentially affecting patients' psychological adjustment abilities.

Aim: To explore the differences in psychological adjustment patterns among ovarian cancer patients receiving surgery, chemotherapy, targeted therapy, and combined therapy, and to analyze their relationship with clinical outcomes.

Methods: A retrospective analysis was conducted on the clinical data of 286 ovarian cancer patients who received different treatment modalities from January 2020 to December 2023. Patients were divided into surgery group (n = 78), chemotherapy group (n = 65), targeted therapy group (n = 61), and combined therapy group (n = 82). The Self-Rating Anxiety Scale, Self-Rating Depression Scale, and Psychological Adjustment to Cancer Scale were used to assess psychological status, while quality of life, treatment adherence, and two-year survival rate data were collected. Some patients (n = 76) received systematic psychological intervention, and the intervention effects were evaluated.

Results: Patients in the combined therapy group had significantly higher Self-Rating Anxiety Scale (56.3 ± 7.2) and Self-Rating Depression Scale (58.4 ± 6.9) scores than other groups, with the highest incidence of anxiety (58.5%) and depression (62.2%); the targeted therapy group scored highest in the positive coping dimension (28.5 ± 3.6) and had the lowest incidence of anxiety and depression (29.5%/31.1%). Logistic regression analysis showed that positive coping (odds ratio = 2.86, 95% confidence interval: 1.75-4.68) and utilization of social support (odds ratio = 2.13, 95% confidence interval: 1.42-3.56) were protective factors for good treatment adherence. Longitudinal assessment showed that although all patients experienced increased anxiety and depression symptoms at 3 months of treatment, the targeted therapy group and surgery group showed significant improvement at 6 months (P < 0.05), while the combined therapy group showed no significant improvement. Psychological intervention effectively improved patients' treatment adherence (by 22.7%) and quality of life (by 15.6 points), with the best effect in the combined therapy group (anxiety incidence decreased by 30.5%, P < 0.001).

Conclusion: Different treatment modalities significantly affect the psychological adjustment abilities of ovarian cancer patients, with combined therapy patients facing greater psychological challenges, while targeted therapy patients exhibit healthier psychological adjustment patterns.

Background: The rural elderly in China have a high prevalence of depressive symptoms, which is closely linked to poor sleep quality. This not only poses significant threats to their physical and mental health but also lacks in-depth exploration of associations specific to different sleep dimensions. We hypothesize that specific sleep dimensions are independently and significantly associated with depressive symptoms in this population.

Aim: To explore the links between different sleep dimensions and depressive symptoms among rural elderly in China.

Methods: This cross-sectional study enrolled 5136 older adults (≥ 60 years) recruited between April and June 2024. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index, and depressive symptoms were assessed with the Patient Health Questionnaire-9. Binary logistic regression analysis was employed to examine the associations between problems in different sleep dimensions and depressive symptoms among these older adults.

Results: The prevalence of depressive symptoms was 19.5%, and the overall rate of sleep disorders was 40.13%. Among the rural elderly, six sleep dimensions were found to be statistically significantly associated with depressive symptoms (all P < 0.05), with the following odds ratios (ORs) and 95% confidence intervals (CIs): Subjective sleep quality (OR = 2.066, 95%CI: 1.709-2.497), sleep onset latency (OR = 2.476, 95%CI: 2.062-2.972), sleep efficiency (OR = 1.686, 95%CI: 1.369-2.076), sleep disturbances (OR = 2.092, 95%CI: 1.566-2.795), daytime dysfunction (OR = 3.378, 95%CI: 2.882-3.959), and use of hypnotic medications (OR = 1.662, 95%CI: 1.093-2.525).

Conclusion: Poor subjective sleep quality, prolonged sleep onset latency, reduced sleep efficiency, sleep disturbances, daytime dysfunction, and use of hypnotic medications are associated with depressive symptoms in the elderly. Therefore, healthcare professionals should target elderly individuals with sleep disorders and implement effective interventions to alleviate their depressive symptoms.

Background: Attention deficit hyperactivity disorder (ADHD) affects approximately 5% of children worldwide and is associated with significant academic impairment. Parents of children with ADHD experience elevated stress and anxiety levels, which may further affect their children's educational outcomes. This prospective study examined the relationship between parental anxiety and academic performance of children with ADHD over a 6-year period.

Aim: To investigate the longitudinal impact of parental anxiety on academic performance in children with ADHD and explore the mediating and moderating factors over a 6-year follow-up period.

Methods: A longitudinal cohort study was conducted from 2018 to 2024, enrolling 118 children with ADHD (aged 6-12 years) and their parents from three specialized educational centers. Parental anxiety was assessed using the Parenting Stress Index-4 (PSI-4) and Parental Anxiety Scale. Children's academic performance was measured using the Academic Performance Questionnaire and standardized achievement tests. Assessments were conducted at baseline and every 6 months for 3 years.

Results: Higher parental anxiety scores were significantly associated with poorer academic performance in children with ADHD (β = -0.42, P < 0.001). Children of parents with clinically significant anxiety (PSI-4 scores > 85^th percentile) showed 1.2 standard deviations lower academic achievement than children of parents with normal anxiety levels. The relationship was partially mediated by parent-child interaction quality (indirect effect = -0.18, 95%CI: -0.26 to -0.10) and homework supervision practices (indirect effect = -0.15, 95%CI: -0.22 to -0.08).

Conclusion: Parental anxiety could significantly affect the academic outcomes of children with ADHD via multiple pathways. Interventions targeting parental mental health may improve the educational outcomes of children with ADHD.

Background: Perinatal anxiety disorder is the main problem affecting mother-infant bonding. Though the impact of perinatal anxiety in primiparous women on the mother-infant relationship is well established, appropriate interventions need to be explored.

Aim: To explore the synergistic intervention effect of mindfulness-based stress reduction combined with cognitive behavioral therapy (CBT) on perinatal anxiety disorders and mother-infant bonding in primiparas.

Methods: A total of 150 primiparas with perinatal anxiety disorders admitted to the hospital from January 2020 to October 2024 were selected and divided into two groups according to the random number method. The control group (n = 75) received CBT, and the observation group (n = 75) received mindfulness-based stress reduction combined with CBT. The anxiety and depressive emotions, as well as the mother-infant emotional bonding situation, were compared between the two groups.

Results: After the intervention, the anxiety and depressive states in the observation group were lower than those in the control group (P < 0.05). The mother-infant bonding (sense of pleasure, recognition, understanding, and love) in the observation group was higher than that in the control group, and the role adaptation ability was also higher than in the control group (P < 0.05).

Conclusion: Mindfulness-based stress reduction combined with CBT can reduce perinatal anxiety disorders in primiparas, promote mother-infant bonding, and improve their ability to adapt to the mother role.

Autism spectrum disorder is a mental neurodevelopmental condition characterized by social deficits and repetitive behavior, and its development is influenced by genetic and environmental factors. Furthermore, an important factor in etiology is the health status of the mother during pregnancy. Maternal health can critically affect the development of the offspring's nervous system, including the central nervous system and enteric nervous system. Unfavorable maternal health can disrupt the normal development of the offspring's nervous system in various ways, such as changes in microbiota composition. As one of the common comorbidities of autism spectrum disorder, no consistent conclusion has been drawn on how poor maternal health affects enteric nervous system and central nervous system development in offspring. From the perspective of maternal health, this review discusses how maternal status affects the gastrointestinal health of offspring and the development of mental systems to raise public awareness of maternal health and provide a new idea for eugenics and childbearing.

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by difficulties in social communication, restricted interests, and repetitive stereotyped behaviors. In recent years, the prevalence of ASD has continued to rise, with boys having a significantly higher incidence rate than girls. Children with ASD often have intellectual and language impairments, which seriously affect their social skills, emotional regulation, and daily life. Although traditional treatment methods have shown some effectiveness, they still have limitations in addressing social and emotional regulation. Neurobiofeedback therapy is a noninvasive, drug-free treatment method that helps individuals regulate physiological responses through feedback mechanisms, and it has shown potential in various psychological disorders and emotional regulation. However, there is limited research on the social skills and emotional regulation in children with ASD. Therefore, this study aims to explore the impact of neurobiofeedback technology on children with ASD through a retrospective cohort study, supplementing existing treatment methods and promoting a more comprehensive treatment of ASD.

Aim: To investigate the effects of neurobiofeedback therapy on social skills and emotional regulation in children with ASD.

Methods: A retrospective study was conducted on 92 children with ASD who were admitted to our hospital from January 2023 to June 2024. According to their different treatment plans, they were divided into a conventional group (conventional rehabilitation treatment; n = 43) and a combined group (conventional rehabilitation treatment combined with neurobiofeedback therapy; n = 49). The general characteristics, Aberrant Behavior Checklist scores, Chinese version of the Psycho-Educational Profile, Third Edition scores, Social Responsiveness Scale scores, Emotion Regulation Checklist scores, Social Communication Questionnaire scores, and the incidence of adverse reactions were compared between groups.

Results: After intervention, the Aberrant Behavior Checklist and Social Responsiveness Scale scores of the combined group were lower than those of the conventional group. In contrast, scores on the Chinese version of the Psycho-Educational Profile, Third Edition, Emotion Regulation Checklist, and Social Communication Questionnaire were significantly higher in the combined group than in the conventional group (all P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups.

Conclusion: Neurobiofeedback therapy can effectively improve clinical symptoms, emotional regulation, and social skills in children with ASD.

Background: Insomnia is closely associated with anxiety and depression, with its pathogenesis involving biological, psychological, and social factors. Sini powder and Suanzaoren decoction are clinically effective traditional Chinese medicine formulas for insomnia, demonstrating promising bioactivity. However, the capability of the active components of Sini-Suanzaoren decoction (SNSZRD) to cross the blood-brain barrier (BBB) and their precise molecular mechanisms, particularly concerning the MT-SIRT1 pathway and mitochondrial function, remain largely unexplored.

Aim: To elucidate the bioactive components of SNSZRD that are capable of BBB penetration and investigate the therapeutic mechanism of SNSZRD against insomnia.

Methods: The chemical components of SNSZRD were analyzed through liquid chromatography-mass spectrometry (LC-MS). Male Sprague-Dawley rats were intraperitoneally injected with DL-4-chlorophenylalanine (PCPA) to establish an insomnia model. Rats were divided into control, model, eszopiclone (positive control), and SNSZRD low-/medium-/high-dose groups. Molecular docking predicted BBB-penetrating components and their binding affinity for SIRT1. Key pathways were analyzed through open-field tests, elevated plus-maze tests, pentobarbital-induced sleep experiments, Haematoxylin and eosin staining, Nissl staining, ELISA, Western blot analysis, quantitative real-time PCR, and immunohistochemistry.

Results: LC-MS identified 1574 compounds in SNSZRD, of which eight prototype components (e.g., pachymic acid and senkyunolide G) could cross the BBB. Molecular docking revealed that these components formed stable hydrogen bonds with the SIRT1 protein. SNSZRD treatment significantly ameliorated PCPA-induced anxiety-like behaviors and sleep latency/sleep duration, as well as reduced neuronal degeneration and Nissl body loss in the hypothalamus of treated rats. Additionally, SNSZRD elevated serum melatonin and hypothalamus ATP levels and upregulated the mRNA and protein expression levels of arylalkylamine N-acetyltransferase, SIRT1, PPARγ coactivator-1α, nuclear respiratory factor-1, and mitochondrial transcription factor A in the MT-SIRT1-mitochondrial biogenesis pathway.

Conclusion: SNSZRD might exert its therapeutic effects on insomnia by modulating MT-SIRT1 axis-regulated mitochondrial biogenesis in rats and might serve as an effective therapeutic agent for insomnia.