International Journal of Psychiatry in Medicine最新文献

Background: Kratom, derived from the Mitragyna speciose, a plant native to Southeast Asia, is a substance that is gaining popularity in the United States as a tool for self-medicating in opiate withdrawal and pain management. Its active compounds, mitragynine and 7-hydroxymitragynine, interact with various receptors in the body, resulting in a spectrum of clinical effects.

Case: A 56-year-old male with a history of depression and cannabis use disorder arrived at the emergency department in a state of severe agitation with erratic behavior and aggression. Further evaluation revealed a recent abrupt discontinuation of Kratom use. A psychiatric consultation was requested and performed by the consultation liaison team, diagnosing Kratom withdrawal as the most likely cause of his acute mania.

Conclusions: Neuropsychiatric symptoms arising from Kratom toxicity is a well-documented phenomenon. However, to our knowledge, this is the first documented case of acute mania induced by Kratom withdrawal.

Objective: Cyberbullying is defined as online aggressive behavior that involves insulting or threatening others, and has been shown to cause severe psychological distress, particularly in students. This is often attributed to the frequency and anonymity of the bullying behaviors. Given the lack of research on this issue in Saudi Arabia, the current study sought to evaluate the prevalence of cyberbullying and its relationship with anxiety, depression, and stress among university students in Jeddah.

Methods: In this cross-sectional study, an online questionnaire was administered to 877 university students in Jeddah. Cyberbullying and cybervictimization were assessed using the Revised Cyberbullying Inventory scale (RCBI-II) and the Depression, Anxiety, and Stress Scale - 21 Items (DASS-21).

Results: The majority of students had the experience of being a cyberbully (73%), while 54% reported being a victim of cyberbullying. No significant association was found between gender and cyberbullying, with both males and females reporting high rates of cyberbullying. The majority of participants (n = 498) also reported significant depressive symptoms. A significant positive association was found between cyberbullying/cybervictimization and depression, anxiety, and stress.

Conclusion: Many university students in this study were found to be victims of cyberbullying, and there was a strong correlation between cyberbullying and anxiety, depression, and stress, indicating a potential impact on the psychological well-being of students. To address this issue, increased awareness of cyberbullying is needed, along with implementation of preventive measures such as educational campaigns and empathy-building activities among students.

Objective: This study examined the prevalence and correlates of generalized anxiety disorder (GAD) among primary care outpatients.

Method: A multicenter, cross-sectional study was conducted that included 707 primary care outpatients being seen at 20 primary healthcare centers in Tunis and Sfax, Tunisia. The Mini International Neuropsychiatric Interview was used to identify a diagnosis of GAD. The Beck Depression Inventory was used to assess depressive symptom severity, and the Sheehan Disability Scale (SDS) was used to measure functional impairment.

Results: The prevalence of GAD was 11%. GAD was positively correlated with female gender (P = .005), family history of psychiatric disorder (P < .001), personal history of suicide attempt (P = .019), and depressive symptoms (P < .001). Based on the SDS, severe to very severe functional limitations were reported at work (56.4%), in social life (60.2%), and family life (73.1%) among GAD patients.

Conclusion: This study indicated a relatively high prevalence of GAD among primary care patients in Tunisia. Risk factors were also determined that may help to identify these patients. This information may help primary care physicians recognize this diagnosis and provide timely referrals to mental health professionals to prevent complications and maximize quality of life.

Objectives: Low back pain (LBP) is a widespread health problem that poses a severe economic burden on both affected patients and the societies in which they live. The purpose of this study was to examine the association between depression and low back pain among patients seen at an orthopedic clinic and determine the association with physical disability.

Methods: A cross-sectional study was carried out in the orthopedic clinics of Al-Badaya General Hospital in the Qassim Region, Saudi Arabia. All patients with LBP seen in the clinic between April and June 2024 were included in the study. A questionnaire was administered that collected demographic information, asked about medical history and behaviors, and included the Arabic-validated version of the Roland-Morris Disability Questionnaire (RMDQ) and the Patient Health Questionnaire (PHQ-9; depression). Multivariate logistic regression analysis was performed to identify correlates of depression.

Results: A total of 365 patients were included in the study. Age ranged between 18 and 85 years, with a mean of 47.9 years (55.6% female). The overall prevalence of depression was 56.2%; 40.3% was mild, 13.2% moderate, and 2.7% moderately severe or severe based on PHQ-9 cutoff scores. Patients with moderately severe/severe depression had the highest disability score, while those with no depression had the lowest disability score. Multivariate logistic regression analysis revealed that with each unit increase in disability score, there was a 20% increase in depression (adjusted odds ratio = 1.20, 95% CI = 1.14-1.26, P < 0.001).

Conclusion: Depression, although mostly mild, was common in this clinic sample of orthopedic patients with chronic LBP and was frequently associated with disability. Disability can be a serious complication of chronic LBP and is often closely linked with depression. As a result, patients with chronic LBP seen at orthopedic clinics in Saudi Arabia (and likely other Middle Eastern countries) should be screened for depression and managed accordingly.

Objective: The present study examined the prevalence and correlates of insomnia and fatigue in patients with type-2 diabetes in Jordan.

Methods: This was a cross-sectional online study involving a convenience sample of 390 patients with type-2 diabetes. Insomnia was assessed by the Insomnia-Severity Index (ISI-A) and fatigue by the Brief Fatigue Inventory (BFI-A).

Results: Severe insomnia was present in 132 patients (33.8%), and was correlated with length of diabetes (diagnosis >5 years) (OR = 2.13, 95% CI = 1.19-3.81, P = 0.01), presence of uncontrolled diabetes (OR = 1.97, 95% CI = 1.45-2.69, P < 0.001), taking gabapentin (OR = 2.07, 95% CI = 1.07-4.01, P = 0.003), and age (<40 years) (OR = 0.30, 95% CI = 0.13-0.69, P = 0.005). Significant fatigue was also prevalent and correlated with gender (female) (B = 9.25, t = 4.48, P < 0.001), age (<40 years) (B = 7.56, t = 2.56, P = 0.01), a diagnosis of hypertension (B = 4.74, t = 2.03, P = 0.04), uncontrolled diabetes (B = 7.21, t = 4.82, P < 0.001), and taking a sulfonylurea (B = 8.03, t = 3.37, P < 0.001), carbamazepine (B = 10.93, t = 2.65, P = 0.008), or gabapentin (B = 12.60, t = 3.83, P < 0.001).

Conclusion: Given the high prevalence of insomnia and fatigue in this population, increased attention by primary healthcare providers to these symptoms in diabetic patients is warranted, particularly in developing countries such as Jordan.

Objective: This study examined the prevalence and correlates of fibromyalgia and insomnia in a convenience sample of Women with Multiple Sclerosis (WMS).

Methods: The study was cross-sectional in design and recruited a sample of 163 women with Relapsing-Remitting Multiple Sclerosis (RRMS). Fibromyalgia was assessed using the Patient Self-Report Survey (PSRS), which follows criteria outlined by the American College of Rheumatology. Insomnia was measured using the Arabic version of the Insomnia Severity Index (ISI-A).

Results: The prevalence of fibromyalgia and insomnia was 28.2% (n = 46) and 46.3% (n = 76), respectively. Multivariate analyses were used to determine significant independent correlates. Fibromyalgia was associated with age above 40 years (OR = 2.29, 95% CI = 1.01-5.18, P = .04), high school education (OR = 3.69, 95% CI = 1.62-8.37, P = .002), and non-use of analgesics (OR = .02, 95% CI = .004-.21, P = .001). Insomnia symptoms were significantly associated only with age above 40 years (OR = 2.16, 95% CI = 1.16-4.04, P = .01).

Conclusion: These findings highlight the need for increased attention by primary care physicians towards diagnosing and treating fibromyalgia and insomnia among women with RRMS in Jordan, particularly for older women.

Objective: Tramadol is a synthetic opioid widely used in clinical practice to treat moderate to severe pain. While it is considered safer than traditional opioids, growing concerns have emerged regarding its adverse psychological effects. This systematic review examined tramadol-induced psychological side effects, identified risk factors, and evaluated possible underlying mechanisms that might help to guide safer clinical use.

Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, and Google Scholar using the related keywords of tramadol and psychological effects. This review primarily focused on case reports, which were included if they provided detailed accounts of tramadol-induced mental health side-effects. Two independent reviewers screened the studies, and data was extracted on patient demographics, details of tramadol usage, psychological outcomes, and risk factors. The quality of the case reports was assessed using the Joanna Briggs Institute (JBI) scale.

Results: The review found that tramadol is associated with a range of psychological symptoms, including manic episodes, hypomania, serotonin syndrome, psychosis, and cognitive impairment. Risk factors included age, pre-existing psychiatric conditions, polydrug use, and prolonged tramadol use. Elderly individuals and those with psychiatric histories were particularly vulnerable.

Conclusion: Tramadol has the potential to cause serious psychological side effects, prompting cautious prescription, especially in vulnerable populations. Clinicians should closely monitor patients for these adverse effects, and further research is needed to understand the mechanisms involved and to reduce the psychological site-effects resulting from tramadol use.

Objective: Alcohol withdrawal syndrome poses a significant health burden worldwide, with its prevalence steadily rising in countries like India due to high rates of alcohol use disorders. The treatment landscape for alcohol withdrawal syndrome is evolving with the introduction of bromocriptine offering a promising adjunctive treatment for patients resistant to standard benzodiazepine therapy.

Methods: We report two cases from India of severe alcohol withdrawal syndrome successfully treated with bromocriptine.

Results: There were clinically significant improvements in both patients with regard to Alcohol Withdrawal Symptoms in a relatively short time span.

Conclusions: Bromocriptine represents an addition to the therapeutic options for alcohol withdrawal syndrome management, offering symptom relief, improving clinical outcomes, and addressing the neuropsychiatric burden associated with the condition.

Objective: There is only limited research on suicidal thoughts and behaviors of oncologists. This study examined the prevalence and correlates of suicidal thoughts among oncologists in Serbia.

Method: A cross-sectional study was conducted in January 2024 involving 159 oncologists from Serbia and the Republic of Srpska. Respondents completed an online questionnaire which assessed socio-demographic and work characteristics and included the Risk Assessment Suicidality Scale, Depression Anxiety Stress Scale-21, Maslach Burnout Inventory, and Brief Resilience Scale.

Results: Results indicated that 21.4% of oncologists reported elevated suicidality scores. Medical oncologists had the highest average suicidality scores compared to surgical and radiation oncologists, although these differences were not statistically significant. Key associated factors with suicidality included seeing a psychiatrist, undergoing psychiatric therapy, having family history of depression, and family history of suicide attempts and/or suicide. Resilience and sense of personal accomplishment were inversely associated with suicidality.

Conclusions: The finding that 1 out of 5 oncologists had elevated suicidality scores underscores the urgent need for mental health support for members of this profession, particularly those showing signs of distress. Interventions should promote resilience, enhance personal accomplishment, and ensure easy access to psychiatric care. While these results contribute to the limited data on suicidality among oncologists, they also identify gaps that future studies should address, such as the need for larger sample sizes and the exploration of other potential risk factors. Addressing oncologists' mental health challenges is critical to reducing suicide risk and fostering well-being in this high-risk profession.