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Beyond a single diagnosis: disentangling midlife depressive symptoms as predictors of dementia 超越单一诊断:解开中年抑郁症状作为痴呆的预测因子
IF 64.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-15 DOI: 10.1016/s2215-0366(25)00389-x
Beatriz Pozuelo Moyano, Christoph Mueller, Robert Stewart
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引用次数: 0
Specific midlife depressive symptoms and long-term dementia risk: a 23-year UK prospective cohort study 特定的中年抑郁症状和长期痴呆风险:一项为期23年的英国前瞻性队列研究
IF 64.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-15 DOI: 10.1016/s2215-0366(25)00331-1
Philipp Frank, Archana Singh-Manoux, Jaana Pentti, G David Batty, Andrew Sommerlad, Andrew Steptoe, Gill Livingston, Robert Howard, Mika Kivimäki
<h3>Background</h3>Midlife depression has been associated with an increased risk of dementia, but it remains unclear whether this risk is attributable to specific symptoms. We aimed to identify the midlife depressive symptoms most strongly linked to subsequent dementia and to ascertain whether these associations were independent of established dementia risk factors.<h3>Methods</h3>In this prospective, observational cohort study based on the UK Whitehall II study, participants (aged 35–55 years at study inception [1985–88]) were eligible for analysis if they had complete depression data and successful linkage to national health records; individuals with prevalent dementia at baseline were excluded. In 1997–99, the baseline for this analysis, participants underwent a clinical examination and completed the 30-item version of the General Health Questionnaire (GHQ-30, a validated screening instrument for detecting clinically significant psychiatric distress in the general population). Threshold-level depression was defined as a GHQ-30 score of 5 or higher. The primary outcome was incident dementia, ascertained via linkage to UK National Health Service (NHS) Hospital Episode Statistics for inpatient admissions, the Mental Health Services Data Set, or the NHS Central Registry for mortality from April 24, 1997, to March 1, 2023. Analyses were conducted using a series of multivariable-adjusted Cox proportional hazards regression models. Hazard ratios (HRs) and accompanying 95% CIs were adjusted for age, sex, and ethnicity in the basic model. People with lived experience were not involved in the study design or writing process.<h3>Findings</h3>Of 6511 participants in the Whitehall II study who completed the GHQ-30 between April 24, 1997, and Jan 8, 1999, 5811 were eligible for this analysis. The mean age of participants was 55·7 years (SD 6·0; range 45–69); 1646 (28·3%) participants were women, 4165 (71·7%) were men, 5356 (92·2%) reported their ethnicity as White, and 455 (7·8%) reported their ethnicity as non-White. During a mean follow-up of 22·6 years (SD 5·0), 586 participants (10·1%) developed dementia. Six depressive symptoms emerged as robust midlife indicators of increased dementia risk: “Losing confidence in myself” (HR 1·51, 95% CI 1·16–1·96), “Not able to face up to problems” (1·49, 1·09–2·04), “Not feeling warmth and affection for others” (1·44, 1·06–1·95), “Nervous and strung-up all the time” (1·34, 1·03–1·72), “Not satisfied with the way tasks are carried out” (1·33, 1·05–1·69), and “Difficulties concentrating” (1·29, 1·01–1·65). Associations were independent of established dementia risk factors, including <em>APOE</em>ε4 status, cardiometabolic conditions, and lifestyle factors. In individuals younger than 60 years at baseline, the six symptoms fully accounted for the association between midlife depression and dementia risk.<h3>Interpretation</h3>A distinct set of midlife depressive symptoms was associated with an increased risk of dementia,
背景:中年抑郁与痴呆风险增加有关,但这种风险是否与特定症状有关尚不清楚。我们的目的是确定中年抑郁症状与随后的痴呆最密切相关,并确定这些关联是否独立于已确定的痴呆危险因素。在这项基于英国Whitehall II研究的前瞻性、观察性队列研究中,参与者(研究开始时年龄为35-55岁[1985-88])如果有完整的抑郁数据并成功地与国家健康记录联系,则有资格进行分析;基线时患有普遍痴呆的个体被排除在外。在1997 - 1999年,作为这项分析的基线,参与者接受了临床检查,并完成了30个项目的一般健康问卷(GHQ-30,一种有效的筛查工具,用于检测一般人群中临床上显着的精神困扰)。阈值水平抑郁症定义为GHQ-30评分为5分或更高。主要结局为痴呆发生率,通过与1997年4月24日至2023年3月1日英国国家卫生服务(NHS)住院患者住院事件统计数据、精神卫生服务数据集或NHS中央死亡率登记处的联系确定。采用一系列多变量校正Cox比例风险回归模型进行分析。在基本模型中,根据年龄、性别和种族调整风险比(hr)和随附的95% ci。有生活经验的人没有参与研究设计或写作过程。在1997年4月24日至1999年1月8日期间完成GHQ-30测试的6511名白厅II研究参与者中,有5811人符合本分析的条件。参与者的平均年龄为55.7岁(SD 6.0,范围45-69);1646(28.3%)名参与者为女性,4165(71.7%)名参与者为男性,5356(92%)名参与者为白人,455(7.8%)名参与者为非白人。在平均22.6年(标准差5.0)的随访期间,586名参与者(10.1%)出现痴呆。6种抑郁症状是痴呆风险增加的中年指标:“对自己失去信心”(HR为1.51,95% CI为1.16 - 1.96)、“无法面对问题”(HR为1.49,95% CI为1.09 - 2.04)、“对他人感觉不到温暖和感情”(HR为1.44,95% CI为1.06 - 1.95)、“总是紧张和紧张”(HR为1.34,95% CI为1.03 - 1.72)、“对任务执行方式不满意”(HR为1.33,95% CI为1.05 - 1.69)、“注意力难以集中”(HR为1.29,95% CI为1.01 - 1.65)。关联独立于已确定的痴呆风险因素,包括APOEε4状态、心脏代谢状况和生活方式因素。在60岁以下的人群中,这六种症状完全解释了中年抑郁和痴呆风险之间的联系。一组独特的中年抑郁症状与痴呆风险增加相关,表明这些症状可能是潜在神经退行性过程的早期标志。这些发现可以为有痴呆风险的抑郁症患者提供更早的识别和更有针对性的干预措施。资助:威康信托基金、英国医学研究委员会、国家老龄化研究所和芬兰研究委员会。
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引用次数: 0
Longitudinal associations between adolescent body dissatisfaction, eating disorder and depressive symptoms, and BMI: a UK twin cohort study 青少年身体不满、饮食失调和抑郁症状与BMI之间的纵向关联:一项英国双胞胎队列研究
IF 64.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-10 DOI: 10.1016/s2215-0366(25)00333-5
Ilaria Costantini, Thalia C Eley, Jean-Baptiste Pingault, Neil M Davies, Helen Bould, Cynthia M Bulik, Georgina Krebs, Glyn Lewis, Gemma Lewis, Clare Llewellyn, Phillippa C Diedrichs, Dasha Nicholls, Francesca Solmi
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引用次数: 0
More than medication 不仅仅是药物
IF 64.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-10 DOI: 10.1016/s2215-0366(25)00361-x
Jonathan Henssler
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引用次数: 0
NMDAR autoantibodies modify the phenotype of psychosis in severe brain inflammation NMDAR自身抗体改变严重脑炎症患者精神病的表型
IF 64.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-10 DOI: 10.1016/s2215-0366(25)00327-x
Niels Hansen, Imke Amanzada, Vincent Buschatzky, Hannah Benedictine Maier, Daniel Luedecke, Alexandra Neyazi, Berend Malchow, Jens Wiltfang, Karl Bechter
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引用次数: 0
Lancet Psychiatry cover artists associated with Bethlem Gallery 《柳叶刀精神病学》的封面艺术家与伯利恒画廊有关
IF 64.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-10 DOI: 10.1016/s2215-0366(25)00369-4
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引用次数: 0
Heidi Taipale: a curiosity-driven approach to data Heidi Taipale:好奇心驱动的数据处理方法
IF 64.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-10 DOI: 10.1016/s2215-0366(25)00370-0
Cahal McQuillan
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引用次数: 0
Therapeutic family foster care: an overlooked model for severe mental disorders 治疗性家庭寄养:严重精神障碍的一种被忽视的模式
IF 64.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-10 DOI: 10.1016/s2215-0366(25)00356-6
Denis Boucaud-Maitre, Salah Djouadi, Anne Lefebvre, Maturin Tabue-Teguo, Nicolas Franck
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引用次数: 0
From mirror to mind: body dissatisfaction and mental health 从镜子到心灵:身体不满与心理健康
IF 64.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-10 DOI: 10.1016/s2215-0366(25)00366-9
Katrin E Giel, Simone C Behrens, Stephan Zipfel
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引用次数: 0
Comparison of antidepressant deprescribing strategies in individuals with clinically remitted depression: a systematic review and network meta-analysis 临床抑郁症缓解个体抗抑郁药处方策略的比较:系统综述和网络荟萃分析
IF 64.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-10 DOI: 10.1016/s2215-0366(25)00330-x
Debora Zaccoletti, Carlotta Mosconi, Chiara Gastaldon, Lorenzo Benedetti, Carolina Gottardi, Davide Papola, Ottavia Ponzi, Marianna Purgato, Florian Naudet, Ioana Alina Cristea, Corrado Barbui, Giovanni Ostuzzi
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引用次数: 0
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Lancet Psychiatry
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