NEUROPSYCHIATRIE最新文献

Purpose: Perinatal mental illness (PMI) is one of the major health problems during pregnancy and one year after birth (the perinatal period), with robust evidence of its potentially detrimental effects on the parent's and child's health. Many countries have prioritised perinatal and infant mental health care (PIMHC). In Austria, it is currently unknown how many services are available in which region. The paper aims to map the current PIMHC landscape.

Methods: Using publicly accessible sources, such as health reports or organisation websites and supplementary information from experts, we collected data on eight characteristics of services to prevent, early identify, treat or support parents with a PMI. We extracted the information into tables, narratively summarised the results and presented a geographical visualisation of service availability.

Results: While there is currently no standardised nationwide systematic screening for PMI in place, there are a variety of services to support and treat parents with a PMI of different severity in Austria. However, there are large regional variations and gaps in care, particularly regarding specialised PIMHC and trained staff, leading to unequal access. PIMHC primarily addresses mothers and involves many, mostly public, providers and funding sources.

Conclusion: There is an urgent need to reduce the regional disparities regarding specialised PIMHC, ensuring adequate referrals and treatment and reducing inequalities in access to care. The results also call for a national strategy and defined political, administrative and service provider responsibilities based on international evidence-based recommendations. Investing in the training of staff and defined care pathways seems warranted.

Purpose: Social challenges are common in patients with eating disorders (ED). The presence of autistic characteristics often exacerbates social difficulties within this group, potentially affecting treatment outcomes. This study investigates the communication preferences, challenges, dislikes, and support needs of patients with ED, both with and without autistic traits, using a communication passport in a national inpatient ED service.

Methods: An explorative qualitative analysis of 38 completed communication passports was conducted to investigate patients' communication preferences, sensory needs, struggles and dislikes, and areas of support required, paying particular attention to the distinct needs of patients with high levels of autistic traits.

Results: The communication passport provided valuable insights into patients' communication preferences, sensory sensitivities, challenges, and support needed. Patients also used the passports to share information about their strengths, personal identity, and life beyond the hospital.

Conclusion: The communication passport fosters a deeper understanding of patients' needs and may support clinicians in care planning and communication strategies tailored to each patient's needs. Regular evaluation and updates are warranted to ensure its usability and accessibility by the wider care team.

Background: Pain is a multidimensional and subjective experience, and its perception is influenced by sensory, emotional, and behavioral factors. This work aims to evaluate the influence of depression and anxiety in the quantitative and qualitative assessment of chronic pain.

Methods: This is a cross-sectional study carried out at the Multidisciplinary Pain Center of the Clinical Hospital of the Federal University of Minas Gerais. A total of 103 patients were interviewed and evaluated using the following instruments: McGill Questionnaire, visual numerical scale, Hospital Anxiety and Depression Scale and the Medical Outcomes Study SF-36.

Results: The affective, sensory and miscellaneous categories of anxious patients were higher than the nonanxious population (p < 0.05). In the depressed population, the "affective" category was higher than the nondepressed population (p < 0.05). Regarding the anxious and depressed population, the affective, sensory and miscellaneous categories were superior to the nonanxious and nondepressed population (p < 0.05).

Discussion: Depression and anxiety are the most common psychiatric disorders in the population with chronic pain, with a prevalence of 30-40%. In the presence of anxiety and depression, a worse qualitative evaluation was observed. The higher the scores obtained in the assessment of these two mental disorders, the higher the pain index found, and the higher pain index correlates with a lower quality of life.

Conclusion: The presence of anxiety and depression altered the qualitative assessment of pain, making it more unpleasant. The pain index correlated with quality of life without, however, being related to pain intensity.

The sharp rise in the number of predominantly natal female adolescents experiencing gender dysphoria and seeking treatment in specialized clinics has sparked a contentious and polarized debate among both the scientific community and the public sphere. Few explanations have been offered for these recent developments. One proposal that has generated considerable attention is the notion of "rapid-onset" gender dysphoria, which is assumed to apply to a subset of adolescents and young adults. First introduced by Lisa Littman in a 2018 study of parental reports, it describes a subset of youth, primarily natal females, with no childhood indicators of gender dysphoria but with a sudden emergence of gender dysphoria symptoms during puberty or after its completion. For them, identifying as transgender is assumed to serve as a maladaptive coping mechanism for underlying mental health issues and is linked to social influences from peer groups and through social media. The purpose of this article is to analyze this theory and its associated hypotheses against the existing evidence base and to discuss its potential implications for future research and the advancement of treatment paradigms.

Objective: The purpose of this systematic review and meta-analysis is to examine the relationship between childhood maltreatment as a variable of exposure and eating disorders as an outcome.

Methods: PubMed, Web of Science, and Google Scholar were searched to find manuscripts related to the current research. The search was conducted up until October 2023 and limited to the English language. An odds ratio (OR) based on the random effects method was used to combine studies. One subgroup analysis was performed based on the type of eating disorder and another based on the type of childhood maltreatment.

Results: Thirty eligible studies were recognized for this research. Childhood maltreatment was associated with a rate of eating disorders of more than double: OR 2.37 with 95% confidence interval (CI) 1.84-3.06 (P < 0.001; I² = 92.6%). Childhood maltreatment was associated with anorexia nervosa (OR 1.89, 95% CI 1.47-2.42; Z = 5.03; P < 0.001; I² = 0%), bulimia nervosa (OR 2.64, 95% CI 1.34-5.17; Z = 2.82; P = 0.005; I² = 93.1%), and binge eating disorder (OR 1.76, 95% CI 1.38-2.26; Z = 4.52; P < 0.001; I² = 80.2%).

Conclusion: The findings of this research showed that childhood maltreatment significantly increases the risk of eating disorders. Therefore, in understanding the mechanisms related to eating disorders, it is necessary to pay attention to the issue of the childhood living environment and the traumatic experiences of that time.

Objective: Both schizophrenia and type 1 diabetes mellitus (T1D) are known as immune-related disorders. We systematically reviewed observational studies to explore the relationship between schizophrenia or schizoaffective disorder and T1D.

Methods: A preliminary search of articles was completed using the following databases: Airiti Library, CINAHL Complete (via EBSCOhost), OVID MEDLINE, Embase, and PubMed. Two researchers independently assessed each study's quality based on Joanna Briggs Institute (JBI). A narrative review summarized the potential relationship between the two diseases.

Results: Eleven studies were included in the final analysis. Six observational studies investigated the risk of schizophrenia and schizoaffective disorder in patients with T1D. Two studies showed negative correlations, one showed no correlation, and three showed positive correlations. On the other hand, five studies reported the prevalence of T1D in patients with schizophrenia. Two of them showed positive associations, and three others showed no association. Although the majority of the included studies suggested a positive association between the two medical conditions, these studies were still too heterogeneous to draw consistent results.

Conclusion: We found conflicting results regarding the bidirectional relationship between schizophrenia or schizoaffective disorder and T1D. These may stem from differences in study design, sampling methods, or definition of diagnoses, which are essential aspects to consider in future research.

Background: Despite conflicting data, some studies have suggested a pathophysiological relationship between inflammation and attention-deficit/hyperactivity disorder (ADHD).

Methods: Using data from the nationwide and representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS; n = 6922 study participants aged 11-17 years), this post hoc analysis assessed the associations between ADHD and three common inflammatory diseases.

Results: Results showed univariate associations between ADHD and lifetime inflammatory diseases including atopic dermatitis (p = 0.002), otitis media (p = 0.001), and herpes simplex infection (p = 0.032). In logistic regression models adjusted for clinically relevant confounders, we found that ADHD remained a significant predictor of all three inflammatory diseases (atopic dermatitis, Exp(β) = 1.672, 95% confidence interval [CI] 1.239-2.257, p = 0.001; otitis media, Exp(β) = 1.571, 95% CI 1.209-2.040, p = 0.001; herpes simplex, Exp(β) = 1.483, 95% CI 1.137-1.933, p = 0.004).

Conclusion: Our findings demonstrate a positive link between ADHD and peripheral inflammatory diseases, including atopic dermatitis, otitis media, and herpes simplex infection. Further studies are needed to understand the exact pathophysiological mechanisms underlying these associations.