World Journal of Psychiatry最新文献

Background: Sleep disturbances are a prominent feature of bipolar disorder (BD) and often persist even in remission, thereby contributing to poor clinical outcomes. Despite the widespread use of lithium and valproic acid as mood stabilizers, their effects on sleep quality have not been examined in adequate detail.

Aim: To evaluate and compare the effects of lithium and valproic acid on sleep quality in BD patients under remission.

Methods: A total of 130 patients meeting the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for BD in remission were included in this cross-sectional study. The participants were receiving either lithium (n = 78), or valproic acid (n = 52), for a minimum of six months either alone or in combination with antipsychotics. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Comparative analyses between the lithium and valproic acid groups were conducted using independent t-tests, χ ² tests, and ANCOVA, adjusting for key variables such as age, sex, and body mass index.

Results: Both groups demonstrated poor sleep quality, with the mean PSQI scores above the clinical threshold of 5. Patients in the lithium group exhibited significantly better habitual sleep efficiency (lithium: 0.47 ± 0.65, valproic acid: 0.78 ± 0.87, P = 0.009) and fewer sleep disturbances (lithium: 1.26 ± 0.57, valproic acid: 1.61 ± 0.84, P = 0.005). Other sleep parameters, including total sleep duration (P = 0.082) and sleep latency (P = 0.625), did not differ significantly.

Conclusion: Patients in the lithium group showed significantly better habitual sleep efficiency and fewer sleep disturbances compared to those receiving valproic acid, although other sleep parameters did not differ. These findings suggest a potential advantage of lithium in certain aspects of sleep quality in BD patients under remission. Future studies using objective sleep measures and longitudinal designs are warranted to confirm these findings.

Background: The tryptophan-kynurenine (TRP-KYN) pathway may be implicated in the pathophysiology of cognitive impairment and pain severity in major depressive disorder (MDD); however, few studies have explored the intricacies of their interaction.

Aim: To investigate the relationship between the TRP-KYN pathway and cognitive function in MDD patients with and without painful physical symptoms (PPS).

Methods: Seventy patients with MDD were recruited, including 33 and 37 with and without PSS, respectively. The Hamilton Depression Scale, the Hamilton Anxiety Scale, and the Short-form of McGill pain questionnaire (SFMPQ) were used to assess clinical symptoms. Cognitive function was assessed by the MATRICS Consensus Cognitive Battery (MCCB) score. TRP-KYN pathway metabolites' serum levels were measured using high-performance liquid chromatography-tandem mass spectrometry.

Results: The with PPS group exhibited significantly higher TRP-KYN ratios than did the without PPS group; in the former, the SFMPQ scores positively and negatively correlated with the TRP-KYN ratio and total MCCB score, respectively. Regression analysis indicated that body mass index and SFMPQ scores were significantly associated with the TRP-KYN ratio, predicting 30% of the variance.

Conclusion: The TRP-KYN ratio is a potential biomarker for identifying patients with depression accompanied by pain symptoms, and targeting it may represent a novel therapeutic strategy for managing pain in these individuals. Further elucidation of the biological mechanisms underlying cognitive impairment in MDD patients with PPS is warranted.

Schizophrenia is a complex neuropsychiatric disorder marked by positive symptoms (hallucinations, delusions), negative symptoms (affective flattening, social withdrawal), and cognitive deficits. Its etiology reflects both strong genetic liability and environmental influences during critical stages of brain development. Dermatoglyphics, the study of epidermal ridge patterns on fingers, palms, and soles, forms between the 10^th and 16^th weeks of gestation, a key neurodevelopmental period. Because both the epidermis and central nervous system share an ectodermal origin, disturbances during this window may produce parallel alterations in ridge patterns and brain structure. Interest in anthropometric markers of psychiatric illness dates to the 19^th century, when theories of degeneracy proposed physical anomalies as signs of hereditary vulnerability. Although controversial, dermatoglyphics has recently re-emerged as a potential non-invasive biomarker for schizophrenia. This review synthesizes evidence on dermatoglyphic patterns in schizophrenia, emphasizing twin studies, comparisons with bipolar disorder, and integration with related developmental anomalies such as minor physical anomalies and somatotype. A structured search of PubMed and Scopus (January 2004 to December 2024) identified 83 eligible studies. Inclusion criteria encompassed original human research, reviews, or meta-analyses on dermatoglyphics in schizophrenia or related psychotic disorders, while excluding animal studies, non-quantitative case reports, and non-English papers without translation. Consistent findings include reduced total ridge counts, increased fluctuating asymmetry, and greater prevalence of abnormal palmar flexion creases among individuals with schizophrenia. Twin designs show anomalies are more frequent in affected co-twins, even among monozygotic pairs, underscoring prenatal environmental effects. Comparative work suggests schizophrenia and bipolar disorder share some but not all dermatoglyphic alterations, offering potential diagnostic value. Dermatoglyphic analysis is stable, inexpensive, and non-invasive, supporting its promise as an adjunctive biomarker of neurodevelopmental disruption. However, methodological variability and limited standardization currently restrict clinical application. Future research should harmonize measurement techniques and integrate genomic and neuroimaging correlates.

Background: Nervonic acid (NA, C24: 1, w9) is a monounsaturated fatty acid that plays a crucial role in myelination and motor function. It also regulates cognitive and metabolic functions, suggesting that impaired NA metabolism may contribute to the pathophysiology of schizophrenia. Although several studies have measured erythrocyte membrane NA in first-episode psychosis (FEP), findings are conflicting, and the fate of NA in patients with chronic schizophrenia (CSZ) or under long-term antipsychotic treatment schedules remains unknown.

Aim: To measure erythrocyte membrane NA and determine its association with psychopathology and metabolic parameters in drug-naive patients with FEP and antipsychotic-treated patients with CSZ.

Methods: In this study, twenty-one drug-naive patients with FEP, twenty patients with CSZ treated with atypical antipsychotics, and fourteen healthy male subjects were analyzed. Erythrocyte membrane NA was measured using ultrathin capillary gas chromatography, plasma leptin was measured using enzyme-linked immunosorbent assay, and body mass index (BMI) was calculated by using the formula: Weight (kg)/height (m²). Psychiatric symptoms were evaluated using the brief psychiatry rating scale and the positive and negative syndrome scale (PANSS). Pearson correlation coefficient (r) was computed to find the association between erythrocyte membrane NA, PANSS scores, plasma leptin, and BMI.

Results: In patients with FEP, erythrocyte NA was non-significantly increased (about 12%) and negatively correlated with negative symptoms (PANSS-negative symptom scores, r = -0.4323, P = 0.023) but not with positive symptoms (PANSS-positive symptom scores, r = -0.2915, P = 0.09). In patients with CSZ, erythrocyte NA was reduced considerably (about 40%, P < 0.001 vs FEP and about 30% vs control (CNT) subjects, P = 0.037) and negatively correlated with both PANSS-negative symptom scores (r = -0.4562, P = 0.013) and PANSS-positive symptom scores (r = -0.3911, P = 0.041). Additionally, in patients with FEP, erythrocyte NA was not significantly correlated either with BMI (r = -0.2532, P = 0.231) or plasma leptin (r = -0.3001, P = 0.102). However, in patients with CSZ, it did negatively correlate with both BMI (r = -0.4721, P = 0.029) and plasma leptin (r = -0.4701, P = 0.031).

Conclusion: Erythrocyte membrane NA level could be used for predicting the development of metabolic abnormalities, treatment resistance, and prognosis in schizophrenia.

Background: Malignant hepatobiliary and pancreatic (HBP) tumors occur in organs such as the liver, gallbladder, and pancreas. Their primary characteristics include invasive growth, high cellular atypia, and high rates of recurrence and metastasis. HBP tumors pose a serious threat to human health.

Aim: To explore palliative treatment and social support for depression and anxiety in patients with end-stage HBP cancers.

Methods: We retrospectively analyzed 100 patients with end-stage HBP tumors who were admitted to our hospital between January 2021 and January 2024. The control group (n = 47) received routine treatment and intervention, whereas the observation group (n = 53) received palliative treatment and social support. Anxiety and depression levels, social support, quality of life, cancer-related fatigue, and 1-year survival were compared between groups.

Results: There were no significant differences in pre-intervention anxiety, depression, social support, or cancer-related fatigue scores between the two groups (P > 0.05). The post-intervention anxiety and depression scores of the observation group were 30.53 ± 4.15 and 42.04 ± 3.86 points, respectively. Both scores were significantly lower than those in the control group (P < 0.05). The post-intervention social support score of the observation group was 79.04 ± 5.74, which was significantly higher than that of the control group (67.82 ± 5.69; P < 0.05). All dimensions of post-intervention quality of life of the observation group were significantly better than those of the control group (P < 0.05). The post-intervention cancer-related fatigue score of the observation group was 2.63 ± 1.15, which was significantly lower than that of the control group (6.28 ± 1.04; P < 0.05). The 1-year survival rate of the observation group was significantly higher than that of the control group (P < 0.05).

Conclusion: Palliative treatment can relieve pain in patients with medical professional capabilities, and social support can prevent social vulnerability through humanistic care.

Alcohol use has contributed to large disease burdens, and alcohol-related problems are prevalent among patients in general hospitals and primary care settings. This review aims to deepen the understanding of screening, intervention, and treatment referral for alcohol-related problems in these settings. We searched the literature published in English from PubMed, ScienceDirect, and the World Health Organization website. We found that while a series of screening tools can be used, screening rates were low. The awareness of screening should be strengthened. Brief interventions and pharmacotherapy are the two main methods used in general hospitals and primary care settings, with complementary and alternative medicine considered under the framework of integrative medicine. Individuals with severe alcohol-related problems or alcohol use disorders should be referred to specialty treatment for alcohol abuse, but referral is sometimes ignored. A gap exists between general hospitals/primary care facilities and specialized alcohol-related treatment providers. In conclusion, screening, intervention, and referral to treatment comprise a continuum for patients with alcohol-related problems. Opportunities to prevent and manage these problems in general hospitals and primary care settings are abundant, and taking action will promote the addressing of this public health issue.

In this commentary, we respond to Zhao et al's recent paper which focuses on mechanisms underlying insomnia sufferers' engagement with acupuncture. Insomnia, a prevalent condition characterized by difficulty falling asleep and poor sleep quality, is associated with increased risk of cardiovascular disease, diabetes, and psychiatric illness. Acupuncture, a method involving the therapeutic placement of needles, has been widely accepted as a treatment for insomnia with minimal side effects. In fact, clinical trials suggest auricular acupuncture may improve sleep duration more than cognitive behavioral therapy. However, responses to acupuncture vary. Some patients find it extremely beneficial, while others view it as a routine treatment-or avoid it altogether due to needle phobia. Patient engagement is influenced by cultural beliefs, encouragement, motivation, prior experiences, and recommendations from peers or clinicians. Trust in the physician and testimonials from recovered patients are particularly important facilitators. Looking ahead, a holistic approach - integrating acupuncture with meditation, pranayama, yoga, and other restorative practices - may enhance treatment effectiveness and help patients achieve restorative sleep.

Schizophrenia is a multifaceted neurodevelopmental disorder characterized by hallucinations, delusions, cognitive deficits, and emotional dysregulation. The prefrontal cortex (PFC), essential for executive functions, working memory, and emotional regulation, is notably impaired in this condition. This review consolidates current insights into the role of PFC dysfunction in schizophrenia, with a focus on its implications for therapeutic strategies. The neuroanatomical and neurobiological foundations of PFC dysfunction are explored, emphasizing structural abnormalities, functional dysconnectivity, and microcircuit disruptions that contribute to cognitive deficits and impaired decision-making. Clinical implications are discussed, particularly the correlation between PFC dysfunction and the severity and progression of schizophrenia symptoms. Additionally, pharmacological and non-pharmacological approaches aimed at modulating PFC activity are reviewed as potential therapeutic options. In conclusion, a deeper understanding of PFC dysfunction is pivotal for developing targeted treatments, and ongoing research offers promising avenues for enhancing outcomes for individuals affected by this debilitating disorder.

Background: Prediabetes is a high-risk precursor for diabetes development and is associated with increased psychological distress. Conventional pharmacological treatments for prediabetes have limitations, including adverse effects and poor patient compliance. Tuina's abdominal vibration technique, a traditional non-pharmacological intervention, has shown promising results in glycemic regulation. However, its effects on psychological well-being remain largely unexplored.

Aim: To investigate efficacy of abdominal vibration at varying frequencies in Tuina for alleviating psychological and metabolic effects in prediabetes patients.

Methods: A prospective cohort study (April 2025 to April 2026) at Dongfang Hospital of Beijing University of Chinese Medicine included 120 prediabetes patients. Participants were allocated to three groups based on vibration frequency: (1) Low-frequency (400 times/minute, n = 40); (2) Medium-frequency (500 times/minute, n = 40); and (3) High-frequency (600 times/minute, n = 40). All participants received 30-minute sessions three times weekly for 3 months, with follow-up at 6 months and 12 months. Primary outcomes included changes in depression (Beck Depression Inventory-II), anxiety (State-Trait Anxiety Inventory), and stress (Perceived Stress Scale) levels.

Results: After a 3-month intervention period, with follow-ups at 6 months and 12 months, patients in all three groups showed significant improvements in depression, anxiety, and stress scores compared to baseline (P < 0.001). The high-frequency group demonstrated the most substantial psychological improvements (mean reduction in depression scores: 9.2 ± 2.3 points; anxiety: 8.7 ± 2.1 points; stress: 10.4 ± 2.5 points). These psychological improvements correlated significantly with reductions in insulin resistance (r = 0.68, P < 0.001). The high-frequency group also showed the most significant improvements in glycemic parameters, with mean reductions in fasting plasma glucose, 2-hour postprandial glucose, and glycosylated hemoglobin concentrations of 0.92 mmol/L, 1.87 mmol/L, and 0.51%, respectively. Correlation analysis revealed significant associations between improved psychological parameters and enhanced glycemic control.

Conclusion: Tuina's abdominal vibration technique, especially at high frequency reduces depression, anxiety, and stress in prediabetes patients, correlating with enhanced glycemic control and insulin sensitivity, suggesting a bidirectional relationship between psychological and metabolic health.