NEUROPSYCHIATRIE最新文献

Recreational use of psychotogenic drugs has become more common in the last 30 years with consequent increase in drug-induced psychosis; 25-50% of such psychoses progress to schizophrenia within 5 years. Most cases result from abuse of methamphetamine or cannabis. The spread of methamphetamine psychosis has occurred without any liberalisation of laws; it is highly addictive and easy to make in small "kitchen" labs. The increase in cannabis use has been facilitated by a softening of attitudes towards the drug, and in some countries, especially in North America, by legalisation for so-called "medicinal use" and then recreational use. The potency of cannabis has greatly increased, especially in countries that have legalised its use, and the worldwide legal sales of cannabis for 2025 are estimated at $ 65 billion. The consequences are being seen with many reports of increases in the incidence of cannabis-psychosis and schizophrenia. In the 1980s some physicians predicted an epidemic of obesity and diabetes due to changes in diet and life style. Sadly, their predictions were correct. We are now at the beginning of a similar epidemic of drug-induced psychosis. Public education campaigns of the type that decreased tobacco smoking are necessary to avoid psychiatric services being overwhelmed.

Climate change is the predominant global crisis of the 21st century and yet it appears as if not enough attention is being paid to its impact on health including mental health and wellbeing of populations globally. There is an increasing acknowledgement that eco-anxiety, solastalgia and other related conditions are emerging. However, more importantly the international impact of climate change with increasing internal and external migration places increasing strain on healthcare systems and healthcare professionals. The sheer speed of change related to climate factors started over 200 years ago but has accelerated in the past few decades and impacts human beings at multiple levels. Extreme weather events, rising temperatures, and environmental degradation contribute very strongly to both existing and newer psychiatric disorders. Recommendations are made for policymakers, researchers and clinicians about what is needed and how to deliver it.

Background: Older adults with depression are at an increased risk of developing cognitive decline. This study aimed to develop and validate a risk prediction model for mild cognitive impairment (MCI) in older adults with depression in China.

Methods: This study used 2020 China Health and Retirement Longitudinal Study (CHARLS) data, splitting the cohort (70:30) into training and validation sets. Least absolute shrinkage and selection operator (LASSO) regression with ten-fold cross-validation identified key predictors, and binary logistic regression examined MCI risk factors in older adults with depression. A nomogram was developed, with receiver operating characteristic (ROC) curves assessing discrimination, calibration curves for accuracy, and decision curve analysis (DCA) for clinical benefit.

Results: This study included 3512 older adults with depression, 640 (19.9%) of whom had MCI. Binary logistic regression identified age, education level, marital status, residence, pain, internet use, and social participation as significant predictors of MCI in older adults with depression, and these factors were used to construct a nomogram model with good consistency and predictive accuracy. The area under the curve (AUC) values of the predictive model in the training set and internal validation set were 0.78 (95% confidence interval [CI] 0.75-0.80) and 0.75 (95% CI 0.71-0.78); the Hosmer-Lemeshow test results were P = 0.916 and P = 0.749, respectively. ROC analysis of the prediction model showed strong discriminatory ability, calibration curves demonstrated significant agreement between the nomogram model and actual observations, and DCA confirmed a favorable net benefit.

Conclusion: The nomogram constructed in this study is a promising and convenient tool for evaluating the risk of MCI among older adults with depression, facilitating early identification of high-risk individuals and enabling timely intervention.

Background: Although family factors affecting the development of eating disorders (EDs) have been extensively studied, it is unknown whether the age gaps between the parents and their affected child have an impact on the overall psychopathological symptom severity.

Methods: In a cohort of 510 consecutive study participants diagnosed with an ED and treated between 1991 and 2017, we examined the associations between parent-patient age gaps and scores from the self-report Global Severity Index (GSI), which measures overall psychopathological distress and symptom severity of the nine psychopathological themes of the Symptom Checklist-90-Revised (SCL-90-R).

Results: In univariate analysis, the GSI scores correlated significantly and negatively between the ED-affected child and the age gap to both the mother (r = -0.119, p = 0.007) and the father (r = -0.108, p = 0.017). Regression models adjusted for body mass index, living in the parental home, and the education level of the patient as clinically relevant confounders confirmed the significant relationship between the overall psychological distress and the age difference to the mother (exp(β) = -0.091, 95% confidence interval [CI] = -0.022-0.000, p = 0.049). In addition, using the same set of confounders, there was a trend toward an association between GSI scores and the paternal age difference to the ED-diagnosed patients (exp(β) = -0.086, 95% CI = -0.018-0.000, p = 0.063).

Conclusion: The symptom severity is more pronounced in cases of a smaller age gap between the parents and their ED-affected child. In multivariate analysis, a significant association was found between a higher self-rated symptom severity and a smaller maternal age difference to the patient. Future studies should thoroughly investigate the influence of parents' age on their offspring's EDs in search of potential underlying mechanisms.

Since January 2022, assisted suicide has also been legal in Austria under certain legally specified conditions. According to the Constitutional Court, the previous legislation did not align with the "right to self-determination" and was therefore declared unconstitutional [1]. In contrast, countries such as the Netherlands, Belgium, and Switzerland have had a less restrictive legislation on assisted suicide for a longer period of time. The requirement for submitting a request for assisted suicide is that the patient suffers from a terminal illness and that both their decision-making capacity and free will are ensured [1]. This case report of a 47-year-old patient, who suffered from recurrent depressive disorder with a current severe episode and, after two previous suicide attempts, chose assisted suicide in Switzerland, aims to highlight the ethical and legal challenges associated with assisted suicide for psychiatric patients and to emphasize the need for careful consideration between autonomy and the duty of protection.