Journal of Psychosomatic Research最新文献_第7页

Sleep disturbance as a poor prognostic predictor in patients with advanced non-small-cell lung cancer treated with immune checkpoint inhibitors: A prospective study 睡眠障碍是接受免疫检查点抑制剂治疗的晚期非小细胞肺癌患者的不良预后预测因素：前瞻性研究

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-22 DOI: 10.1016/j.jpsychores.2024.111892

Background

Sleep disturbances are highly prevalent in oncology and often exacerbate symptoms, leading to reduced quality of life, which in turn may further affect the tolerability and efficacy of oncological treatments. Sleep disturbance and cancer have an intimate and complicated relationship, and may be a negative predictor of cancer treatment. The present study aimed to characterize the relationship between sleep disturbance and immune checkpoint inhibitor (ICI) therapy in patients with advanced non-small cell lung cancer (NSCLC).

Methods

Data from 171 patients with advanced NSCLC, who underwent ICI treatment between December 2020 and October 2022, were analysed in our prospective study. Sleep disturbances were evaluated according to the Pittsburgh Sleep Quality Index (PSQI), with a cut-off value of 5, to investigate the impact of sleep disturbance on the survival of patients with NSCLC and the efficacy of ICI treatment.

Results

The median progression-free survival (PFS) was10.4 months (9 5% confidence interval [CI]:9.84–10.97). Univariate and multivariate analyses revealed that sleep disturbance and depressive symptom predicted worse prognosis with shortened PFS. Patients who experienced sleep disturbance exhibited a significant reduction in PFS (9.2 vs. 11.8 months; HR: 1.83 [9 5% CI 1.27–2.6 5]; p = 0.001), as did those with depressive states (HR 1.5 5 [9 5% CI 1.06–2.28]; p = 0.02 5). Additionally, patients with sleep disturbance and depressive symptoms exhibited significantly lower objective response rates and disease control rates.

Conclusion

Sleep disturbance could be a factor for prognosis in patients with advanced NSCLC undergoing first- or second-line treatment with ICIs, including shorter PFS and reduced efficacy.

背景睡眠障碍在肿瘤学中非常普遍，它往往会加重症状，导致生活质量下降，反过来又会进一步影响肿瘤治疗的耐受性和疗效。睡眠障碍与癌症的关系密切而复杂，可能是癌症治疗的负面预测因素。本研究旨在描述晚期非小细胞肺癌（NSCLC）患者睡眠障碍与免疫检查点抑制剂（ICI）治疗之间的关系。方法我们的前瞻性研究分析了在2020年12月至2022年10月期间接受ICI治疗的171例晚期NSCLC患者的数据。结果中位无进展生存期（PFS）为10.4个月（9.5%置信区间[CI]：9.84-10.97）。单变量和多变量分析显示，睡眠障碍和抑郁症状预示着预后较差，PFS缩短。睡眠障碍患者的 PFS 明显缩短（9.2 个月 vs. 11.8 个月；HR：1.83 [9 5% CI 1.27-2.6 5]；p = 0.001），抑郁症状患者也是如此（HR 1.5 5 [9 5% CI 1.06-2.28]; p = 0.02 5）。此外，有睡眠障碍和抑郁症状的患者客观反应率和疾病控制率明显较低。

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引用次数: 0

Halifax somatic symptom disorder trial: A pilot randomized controlled trial of intensive short-term dynamic psychotherapy in the emergency department 哈利法克斯躯体症状障碍试验：急诊科短期强化动态心理治疗试点随机对照试验。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-22 DOI: 10.1016/j.jpsychores.2024.111889

Background

Patients commonly present at hospital Emergency Departments (ED) with distress that meet criteria for a Somatic Symptom and Related Disorder (SSRD). Without access to effective treatment, risk of ongoing patient disability and further ED visits is high.

Method

This pilot trial used a randomized parallel group design to test the efficacy of Intensive Short-Term Dynamic Psychotherapy (ISTDP). ED patients who met criteria for SSRD were recruited. The effects of ISTDP plus medical care as usual (MCAU) were judged through comparison against 8 weeks of MCAU plus wait-list symptom monitoring (WL-SM). The primary outcome was somatic symptom at 8 weeks. Patients allocated to WL-SM could cross-over to receive ISTDP and 6-month follow-up data was collected. Baseline measures of patient attachment style and alexithymia were collected to examine vulnerabilities to somatic symptoms. ClinicalTrials.gov: NCT02076867.

Results

Thirty-seven patients were randomized to 2 groups (ISTDP = 19 and WL-SM = 18). Multi-level modelling showed that change over time on somatic symptoms was significantly greater in the ISTDP group. Between-group differences were large at 8 weeks (Cohen's d = 0.94) and increased by end of treatment (Cohen's d = 1.54). Observed differences in symptoms of depression and illness anxiety were also large, favoring ISTDP, and effects were maintained at follow-up. Patients receiving ISTDP had reduced ED service utilization at 2-year follow-up.

Conclusions

ISTDP appears an efficacious treatment for SSRD and a larger randomized trial is justified.

背景：在医院急诊科（ED）就诊的患者通常都有符合躯体症状及相关障碍（SSRD）标准的困扰。如果得不到有效治疗，患者持续致残和进一步到急诊科就诊的风险很高：这项试点试验采用随机平行分组设计，以测试短期强化动态心理疗法（ISTDP）的疗效。试验招募了符合 SSRD 标准的急诊室患者。通过与为期8周的常规医疗护理（MCAU）和候补症状监测（WL-SM）进行比较，判断ISTDP和常规医疗护理（MCAU）的效果。主要结果是 8 周后的躯体症状。接受 WL-SM 治疗的患者可交叉接受 ISTDP 治疗，并收集 6 个月的随访数据。此外，还收集了患者依恋风格和情感障碍的基线测量数据，以检查患者对躯体症状的易感性：NCT02076867.结果：37名患者被随机分为两组（ISTDP=19和WL-SM=18）。多层次建模显示，ISTDP组躯体症状随时间的变化明显更大。8 周时，组间差异较大（Cohen's d = 0.94），治疗结束时，组间差异有所扩大（Cohen's d = 1.54）。抑郁症状和疾病焦虑的观察差异也很大，有利于 ISTDP，而且效果在随访中保持不变。接受ISTDP治疗的患者在2年的随访中减少了对急诊室服务的使用：ISTDP似乎是一种治疗SSRD的有效方法，有理由进行更大规模的随机试验。

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引用次数: 0

Facilitating and hindering factors in the treatment of persistent somatic symptoms in migrants: A scoping review 治疗移民持续性躯体症状的促进因素和阻碍因素：范围界定审查

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-15 DOI: 10.1016/j.jpsychores.2024.111887

Objective

To identify facilitating and hindering factors in the treatment of persistent somatic symptoms (PSS) in migrants in psychiatry and other health care settings in Western countries.

Methods

A scoping literature review was conducted by searching PubMed and Embase, using combinations of search terms related to the treatment of PSS in migrants. Studies outside of the scope of current guidelines or limited to specific underlying diseases such as post-traumatic stress disorder (PTSD) or consequences of torture were excluded. Two independent reviewers verified that the studies met the inclusion criteria, assessed the quality of the studies, and identified and categorized facilitating and hindering treatment factors.

Results

Of the 347 unique citations identified in the initial the search, 18 studies met the inclusion criteria. These studies showed a wide variety in study design, interventions used, measurement instruments, and study quality. Common treatment adaptations related to: (a) translation and interpretation, (b) adaptation to lower educational levels, (c) culture-sensitive therapists and materials, (d) gender roles, (e) removal of practical barriers, (f) supportive treatment, and (g) nonverbal therapy forms. The most commonly mentioned influencing factors of treatment success related to: (a) body and experience-oriented treatment elements, (b) translation and communication, (c) cultural sensitivity, (d) group interaction, and (e) caring for one's own health.

Conclusion

This review provides an overview of available research on treatment adaptations for PSS in migratory background patients. Potential facilitating and hindering factors for treatment success that may be useful for healthcare providers treating PSS in patients with a migratory background were identified.

方法通过检索 PubMed 和 Embase，使用与移民持续性躯体症状（PSS）治疗相关的检索词组合，进行范围性文献综述。不属于现行指南范围或仅限于创伤后应激障碍（PTSD）或酷刑后果等特定潜在疾病的研究被排除在外。两名独立审稿人核实了这些研究是否符合纳入标准，评估了研究质量，并对促进和阻碍治疗的因素进行了识别和分类。这些研究在研究设计、所使用的干预措施、测量工具和研究质量方面存在很大差异。常见的治疗调整涉及(a) 翻译和口译，(b) 适应较低的教育水平，(c) 文化敏感的治疗师和材料，(d) 性别角色，(e) 消除实际障碍，(f) 支持性治疗，(g) 非语言治疗形式。最常被提及的影响治疗成功的因素包括(结语：本综述概述了现有的关于移民背景患者 PSS 治疗适应性的研究。综述指出了治疗成功的潜在促进和阻碍因素，这些因素可能对医护人员治疗具有移民背景的患者的 PSS 有所帮助。

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引用次数: 0

Biomarkers as predictors of CBT responsiveness in major depressive disorder: The role of heart rate variability and inflammation 生物标志物是重度抑郁障碍患者对 CBT 反应性的预测因子：心率变异性和炎症的作用

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-13 DOI: 10.1016/j.jpsychores.2024.111885

Objective

Biological risk factors for cardiovascular disease may relate to poor treatment responsiveness in major depressive disorder (MDD). These factors encompass low-grade inflammation and autonomic dysregulation, as indexed by decreased heart rate variability (HRV) and increased heart rate (HR). This secondary analysis examined whether higher levels of inflammatory markers or autonomic alterations relate to lower responsiveness to cognitive behavioral therapy (CBT) among individuals with MDD.

Methods

Eighty antidepressant-free patients with MDD were randomly assigned to 14 weeks of CBT or waitlist (WL). Potential biological moderators at study entry included HR and HRV (24-h, daytime, nighttime) and inflammatory markers such as C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor (TNF)-α. Forty non-clinical controls were involved to verify biological alterations in MDD at study entry. Depressive symptoms were assessed at baseline and at the end of treatment.

Results

Individuals with MDD exhibited reduced total 24-h HRV (i.e., triangular index) and daytime HRV (i.e., triangular index, HF-HRV, LF-HRV, RMSSD), as well as increased levels of inflammatory markers. Patients who received CBT exhibited stronger reductions in self- and clinician-rated depressive symptoms, compared to WL. False discovery rate-adjusted moderation analyses did not show overall moderating effects of biological measures on treatment responsiveness. However, higher CRP levels were specifically associated with poorer improvement in somatic depressive symptoms.

Conclusions

There was no overall evidence for a moderating role of inflammation or autonomic features in CBT responsiveness in MDD. Higher levels of CRP might, however, specifically be associated with less improvement in somatic depressive symptoms during CBT.

目的心血管疾病的生物风险因素可能与重度抑郁症（MDD）治疗反应不佳有关。这些因素包括低度炎症和自律神经失调，表现为心率变异性（HRV）降低和心率（HR）升高。这项二次分析研究了较高水平的炎症标志物或自律神经改变是否与MDD患者对认知行为疗法（CBT）的较低反应性有关。方法将八名未服用抗抑郁药的MDD患者随机分配到为期14周的CBT或候补名单（WL）中。研究开始时的潜在生物调节因子包括心率和心率变异（24 小时、白天、夜间）以及炎症指标，如 C 反应蛋白 (CRP)、白细胞介素 (IL)-6 和肿瘤坏死因子 (TNF)-α。40名非临床对照者参与了研究，以验证研究开始时多发性硬化症的生物学改变。结果MDD患者的24小时总心率变异（即三角形指数）和日间心率变异（即三角形指数、HF-HRV、LF-HRV、RMSSD）均有所降低，炎症标志物水平也有所升高。与 WL 相比，接受 CBT 治疗的患者自我和临床医生评定的抑郁症状减少更明显。假发现率调整调节分析并未显示生物指标对治疗反应性的总体调节作用。结论没有总体证据表明炎症或自律神经特征对 MDD 的 CBT 反应性有调节作用。然而，CRP水平较高可能与CBT期间躯体抑郁症状改善较差特别相关。

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引用次数: 0

Effectiveness of psychological interventions to decrease cognitive fusion in patients with chronic pain: A systematic review and meta-analysis 心理干预对减少慢性疼痛患者认知融合的效果：系统回顾与荟萃分析

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-13 DOI: 10.1016/j.jpsychores.2024.111888

Objective

While there is sufficient evidence of Acceptance and Commitment Therapy's effectiveness in allowing patients to deal with chronic pain, the effectiveness in cognitive fusion, one of the six core components of the Psychology Flexibility Model, has yet to be established. The aim of this article is to assess whether psychological interventions decrease cognitive fusion.

Methods

The Web of Science, SCOPUS, Medline, and PsycINFO databases were searched for primary studies up to June 2024. Studies with a cognitive fusion measure in which chronic pain patients received a psychological intervention were included. A methodological quality scale was applied to the selected studies and the average effect sizes (Hedges g) were calculated.

Results

This review included 18 articles with 24 studies (19 pre-post/follow-up studies and five randomized control trials). Cognitive fusion decreased significantly after the intervention. The effect sizes were small/medium at post-test, g = -0.39, p < .001, 95% CI [-0.52, -0.26]; and medium at long-term follow-up, g = -0.55, p < .001, 95% CI [−0.74, -0.36]. A similar tendency was found for studies with RCTs at post-test, g = -0.61, p = .006, 95% CI [−1.05, -0.17], short-term follow-up, g = -0.79, p < .001, 95% CI [−1.18, -0.40] and long-term follow-up, g = -0.58, p = .003, 95% CI [-0.95, -0.20]). Moderator variables such as unemployment, gender, pain intensity, level of depression before the intervention, and duration and intervention modality were identified.

Conclusion

Psychological interventions tended to decrease cognitive fusion in chronic pain patients. Nonetheless, more clinical trials are needed to establish the role of cognitive fusion in psychological flexibility.

目的虽然有足够的证据表明接纳与承诺疗法能有效帮助患者应对慢性疼痛，但其对认知融合（心理学灵活性模型的六个核心组成部分之一）的有效性尚未得到证实。本文旨在评估心理干预是否会降低认知融合度。方法在 Web of Science、SCOPUS、Medline 和 PsycINFO 数据库中检索了截至 2024 年 6 月的主要研究。方法在 Web Science、SCOPUS、Medline 和 PsycINFO 数据库中搜索了截至 2024 年 6 月的主要研究，并纳入了慢性疼痛患者接受心理干预的认知融合测量研究。对所选研究采用了方法学质量量表，并计算了平均效应大小（Hedges g）。结果本综述共纳入18篇文章，24项研究（19项前后/随访研究和5项随机对照试验）。干预后，认知融合度明显下降。后测的效应大小为小/中，g = -0.39，p < .001，95% CI [-0.52，-0.26]；长期随访的效应大小为中，g = -0.55，p < .001，95% CI [-0.74，-0.36]。在后测（g = -0.61，p = .006，95% CI [-1.05，-0.17]；短期随访（g = -0.79，p <.001，95% CI [-1.18，-0.40]；长期随访（g = -0.58，p = .003，95% CI [-0.95，-0.20]）中，有 RCT 的研究也发现了类似的趋势。研究还发现了一些调节变量，如失业率、性别、疼痛强度、干预前的抑郁程度、干预持续时间和干预方式等。尽管如此，还需要更多的临床试验来确定认知融合在心理灵活性中的作用。

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引用次数: 0

Different patterns of persistent somatic symptoms after COVID-19 reported by the Dutch media and the general population 荷兰媒体和普通民众报道的 COVID-19 后持续性躯体症状的不同模式

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-13 DOI: 10.1016/j.jpsychores.2024.111886

Objective

Post COVID-19 condition is characterized by persistent symptoms after COVID-19 with yet unknown etiology. To explore whether media-related nocebo effects potentially contribute to post COVID-19 condition, we studied in an observational cohort whether frequencies of media coverage of symptoms after COVID-19 corresponded with prevalence rates of these symptoms in participants from a general population cohort diagnosed with COVID-19.

Methods

Prevalence rates and typology of symptoms after COVID-19 in the general population (N = 4231), adjusted for prevalence rates in a matched non-infected control population (n = 8462) were calculated by using data on 23 symptoms from the Lifelines COVID-19 Cohort collected between March 2020 and August 2021. Media coverage of post COVID-19 condition was assessed by coding 1266 Dutch post COVID-19-related news articles (inter-rater-κ ≥ 0.75), published during the corresponding timeframe. Herein, we assessed whether the same 23 symptoms were mentioned as being related to post COVID-19 condition.

Results

Core post COVID-19 condition symptoms were mentioned in 390 (30.8%) articles. Five of the ten core symptoms were mentioned by 10 or fewer articles. Ageusia/anosmia was most often persistently increased in COVID-19-positive participants (7.6%), yet was mentioned in 80 (6.3%) articles. General tiredness and breathing difficulties were frequently mentioned, in 23.9% and 17.1% of the articles respectively, while these were not the most frequently increased symptoms reported by participants (4.9% and 2.4%).

Conclusion

If post COVID-19 condition was predominantly attributable to nocebo effects, its symptom profile would be expected to reflect levels of media coverage for symptoms after COVID-19. However, our findings do not support this.

目标 COVID-19 后症状的特点是 COVID-19 后症状持续存在，但病因不明。为了探究媒体相关的安慰效应是否可能导致 COVID-19 后遗症，我们在一个观察性队列中研究了媒体对 COVID-19 后遗症的报道频率是否与被诊断为 COVID-19 的普通人群中这些症状的流行率相对应。方法利用 2020 年 3 月至 2021 年 8 月期间收集的生命线 COVID-19 队列中 23 种症状的数据，计算出 COVID-19 后症状在普通人群（N = 4231）中的流行率和类型，并根据匹配的非感染对照人群（N = 8462）的流行率进行调整。通过对相应时间段内发表的 1266 篇与 COVID-19 后相关的荷兰新闻报道进行编码，评估了媒体对 COVID-19 后症状的报道情况（评分间κ≥ 0.75）。结果在 390 篇（30.8%）文章中提到了 COVID-19 后的核心症状。在 10 个核心症状中，有 5 个症状在 10 篇或更少的文章中被提及。在 COVID-19 阳性参与者（7.6%）中，老年躁狂症/嗅觉障碍最常持续加重，但有 80 篇文章（6.3%）提到了这一症状。一般疲倦和呼吸困难也经常被提及，分别在 23.9% 和 17.1% 的文章中被提及，而这些症状并不是参与者报告的最常见的加重症状（4.9% 和 2.4%）。然而，我们的研究结果并不支持这一观点。

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引用次数: 0

A description of the development of an innovative multi-component long COVID treatment program based on central sensitization with preliminary patient satisfaction data 介绍基于中枢敏化的创新性多成分长效 COVID 治疗方案的发展情况，以及患者的初步满意度数据。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-12 DOI: 10.1016/j.jpsychores.2024.111884

Objective

Estimates of the prevalence of Long COVID in the United States or worldwide are imprecise, but millions of people are thought to be affected. No effective treatment exists for the often devastating symptoms of Long COVID. Central Sensitization has been postulated as a causal/explanatory mechanism for developing Long COVID. No treatment to date has targeted Central Sensitization. The present cross-sectional study describes the first 140 patients treated in a multi-component treatment program that targets Central Sensitization to reduce symptom burden, improve functioning, and lower the psychological distress observed in these patients.

Methods

140 patients diagnosed with Long COVID after an extensive medical evaluation were assessed for function, depression, and pain catastrophizing using questionnaires and patient satisfaction measures after completion of a 16-h Cognitive Behavioral Therapy treatment program focused on Central Sensitization.

Results

Upon admission, patients diagnosed with Long COVID were significantly impaired in their ability to function due to their symptoms. Further, 70% of the patients were depressed. Pain catastrophizing was observed in up to 20% of patients.

Conclusion

Patient satisfaction measures were high for the sample at the end of the treatment program suggesting that a multicomponent treatment program targeting Central Sensitization is acceptable to patients. Further research is needed to explore the effectiveness and durability of this treatment approach.

目的：长颈伏牛症在美国或全球的发病率估计并不精确，但据认为有数百万人受到影响。目前还没有有效的治疗方法来治疗长 COVID 通常具有破坏性的症状。中枢致敏被认为是长COVID的致病/解释机制。迄今为止，还没有针对中枢过敏的治疗方法。本横断面研究介绍了针对中枢敏感化的多组分治疗方案的首批 140 名患者的治疗情况，该治疗方案旨在减轻这些患者的症状负担、改善其功能并减轻其心理压力。方法：140 名患者在接受广泛的医学评估后被诊断为 Long COVID，在完成以中枢敏感化为重点的 16 小时认知行为疗法治疗方案后，他们接受了功能、抑郁和疼痛灾难化方面的问卷评估，并接受了患者满意度测量：入院时，被诊断出患有长COVID的患者由于症状明显影响了他们的功能。此外，70%的患者患有抑郁症。多达 20% 的患者出现疼痛灾难化：结论：在治疗计划结束时，样本患者的满意度很高，这表明针对中枢敏感性的多成分治疗计划是可以被患者接受的。还需要进一步研究这种治疗方法的有效性和持久性。

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引用次数: 0

Prevalence of psychotropic medication dispensing to people living with cystic fibrosis in Australia: 2013–2022 澳大利亚向囊性纤维化患者发放精神药物的普遍程度：2013-2022 年

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-08 DOI: 10.1016/j.jpsychores.2024.111877

Objective

People living with cystic fibrosis (PwCF) are at increased risk of mental health conditions. There is little evidence addressing psychotropic medication use in PwCF. This study aimed to estimate the dispensing prevalence of antidepressant, anxiolytic, antipsychotic, psychostimulant, and hypnotic/sedative medication in PwCF in Australia between 2013 and 2022.

Method

A 10% random sample of Australian Pharmaceutical Benefits Scheme data was used to identify PwCF and their medications between 2013 and 2022. Annual prevalence of psychotropic medication dispensing was estimated using a 3-year rolling average, stratified by sex, age, and medication class.

Results

Psychotropic medications were dispensed to 206/478 (41.3%) PwCF. Antidepressant and anxiolytic dispensing prevalence was highest in adult females, increasing from 201 5 by 50% to their peak in 2021 (antidepressants 36.8%; anxiolytics 12.3%). Psychostimulant prevalence was highest in adolescent males and increased over three-fold during the study period from 3.6% to 13.2%. The prevalence of antipsychotic medication was lower than other classes with adult females having the highest prevalence (3.1% and 5.8% in 201 5 and 2022 respectively). Hypnotic/sedative medications remained consistently low or decreased in all groups except male children, where it increased from 0.6% to 2.8% from 201 5 to 2022.

Conclusion

Psychotropic medication use is higher among Australian PwCF compared to the general population, with varying prevalence across age and sex groups. This is of interest due to complexities with CF comorbidities and potential medication influences and interactions. Future studies should investigate the reasons for psychotropic use disparities within PwCF with the aim to establish targeted guidelines and optimize outcomes.

目标囊性纤维化患者（PwCF）罹患精神疾病的风险增加。有关囊性纤维化患者使用精神药物的证据很少。本研究旨在估算 2013 年至 2022 年期间澳大利亚囊肿性纤维化患者的抗抑郁药、抗焦虑药、抗精神病药、精神刺激药和催眠药/镇静药的配药率。结果206/478（41.3%）名贫困家庭接受了精神药物治疗。抗抑郁药和抗焦虑药的配药率在成年女性中最高，从 2015 年开始增加 50%，到 2021 年达到峰值（抗抑郁药 36.8%；抗焦虑药 12.3%）。青少年男性的精神兴奋剂使用率最高，在研究期间增长了三倍多，从 3.6% 增长到 13.2%。抗精神病药物的使用率低于其他类药物，其中成年女性的使用率最高（2015 年为 3.1%，2022 年为 5.8%）。除男性儿童外，催眠/镇静药物在所有群体中的使用率始终较低或有所下降，男性儿童的使用率从 2015 年的 0.6% 上升到 2022 年的 2.8%。由于CF合并症的复杂性以及潜在的药物影响和相互作用，这种情况值得关注。未来的研究应调查造成儿童和成人精神药物使用差异的原因，以制定有针对性的指导原则并优化治疗效果。

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引用次数: 0

Report on the 11th annual EAPM conference in Lausanne, Switzerland 关于在瑞士洛桑举行的第 11 届 EAPM 年度会议的报告

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-08 DOI: 10.1016/j.jpsychores.2024.111882

引用次数: 0

Association between hospital-diagnosed tinnitus and suicide: A Nationwide Danish longitudinal study 医院诊断出的耳鸣与自杀之间的关系：丹麦全国纵向研究。

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research

Pub Date : 2024-08-08 DOI: 10.1016/j.jpsychores.2024.111879

Objectives

Tinnitus is a source of significant distress among some people. Associations have been suggested between tinnitus and mental disorders, and with suicidal thoughts and attempts. However, whether this extends to suicide in the general population remains uncertain.

Methods

This is a retrospective cohort study including all individuals aged 15 years or older, using Danish nationwide, longitudinal, population-based register data from 1 January 1990 through 31 December 2021. The main outcome was death by suicide. Poisson regression models were used to estimate adjusted incidence rate ratios (IRR) with the 95% confidence intervals (CI).

Results

Among 7,438,007 individuals (49.8% males) observed over 144,050,344 person-years, 85,677 (57.7% males) were diagnosed with tinnitus. In all, 23,824 suicide deaths were identified, of which 225 had tinnitus. Suicide rates were 24.2 and 16.5 per 100,000 person-years for those with and without tinnitus, respectively, giving an adjusted IRR of 1.4 (95% CI 1.2–1.6). Suicide rates were adjusted for demographic characteristics, concomitant hearing loss, and co-existing mental disorders before tinnitus. Increased suicide rates were linked to a higher number of hospital contacts and to recent hospital contacts, suggesting dose-response and temporal associations.

Conclusions

The findings reveal an association between tinnitus and suicide, particularly among individuals with co-existing mental disorders. Dose-response and temporal associations were found between tinnitus and suicide. Concurrent hearing loss had no influence on the tinnitus-suicide association. Attention towards patients experiencing tinnitus related distress is warranted, especially those with pre-existing mental disorders.

目的：耳鸣会给一些人带来极大的困扰。有研究表明，耳鸣与精神障碍、自杀想法和企图之间存在关联。然而，这种关系是否会延伸到普通人群中的自杀行为仍不确定：这是一项回顾性队列研究，研究对象包括所有 15 岁或 15 岁以上的人，采用的是丹麦全国范围内从 1990 年 1 月 1 日至 2021 年 12 月 31 日的纵向人口登记数据。主要结果是自杀死亡。研究采用泊松回归模型来估算调整后的发病率比（IRR）及 95% 的置信区间（CI）：在144,050,344人年的7,438,007人（49.8%为男性）中，有85,677人（57.7%为男性）被诊断出患有耳鸣。共发现 23,824 例自杀死亡病例，其中 225 例患有耳鸣。耳鸣患者和非耳鸣患者的自杀率分别为每 10 万人年 24.2 例和 16.5 例，调整后的内部死亡率为 1.4（95% CI 1.2-1.6）。自杀率根据人口统计学特征、伴随听力损失和耳鸣前同时存在的精神障碍进行了调整。自杀率的上升与较高的医院接触次数和最近的医院接触次数有关，这表明存在剂量反应和时间关联：结论：研究结果表明，耳鸣与自杀之间存在关联，尤其是在同时患有精神障碍的人群中。耳鸣与自杀之间存在剂量反应和时间关系。同时存在的听力损失对耳鸣与自杀之间的联系没有影响。因此，我们有必要关注那些因耳鸣而感到痛苦的患者，尤其是那些患有精神疾病的患者。

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