International Journal of Psychiatry in Medicine最新文献

ObjectiveBreast cancer patients undergoing radiotherapy frequently experience psychological distress that negatively impacts treatment outcomes and quality of life. Evidence for structured psychological interventions during radiotherapy remains limited. This study evaluated the longitudinal effects of a structured education plus entertainment therapy intervention on anxiety, depression, and quality of life in mainland China breast cancer patients during and after radiotherapy using linear mixed model analysis.MethodsThis single-center, parallel-group, assessor-blinded randomized controlled trial enrolled 280 female breast cancer patients (aged 18-75 years) receiving adjuvant radiotherapy. Participants were randomized 1:1 to intervention (structured education plus entertainment therapy) or control (standard care). Primary outcomes were Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) trajectories assessed at baseline (T0), mid-radiotherapy (T1), end of radiotherapy (T2), and 1, 3, and 6 months post-radiotherapy (T3-T5). Secondary outcomes included quality of life (EORTC QLQ-C30/BR23 domains), acute toxicity (CTCAE v5.0), and adherence. Linear mixed models with group × time interaction assessed intervention effects.ResultsOf 280 randomized patients, 252 (90%) completed the T5 assessment. The intervention group showed significantly improved SAS trajectory (group × time interaction β = -1.82, 95% CI: -3.14 to -0.50, P = 0.007) with estimated marginal mean difference of -3.45 points at T5. SDS trajectory improvement was marginally significant (β = -1.56, 95% CI: -3.12 to 0.01, P = 0.051). Minimal clinically important difference (MCID, ≥0.5 SD improvement) was achieved by 48.6% vs 31.4% for anxiety (P = 0.004) and 42.1% vs 29.3% for depression (P = 0.027) for intervention and control groups, respectively. Global health status improved significantly (β = 4.23, P < 0.001). Grade ≥2 radiation dermatitis occurred in 37.1% vs 48.6% (P = 0.055) in intervention and control groups, respectively. High adherence (≥70% sessions) in 72.1% of intervention patients was associated with greater benefits.ConclusionsThe structured education plus entertainment therapy intervention demonstrated small-to-moderate clinically meaningful improvements in anxiety, depression, and quality of life during radiotherapy, with effects persisting through 6-month follow-up. Implementation into routine radiotherapy care of breast cancer patients in China appears feasible and effective.

ObjectiveThis study examined the prevalence and predictors of obstructive sleep apnea (OSA) risk in patients with chronic schizophrenia.MethodsA cross-sectional survey was conducted with 441 institutionalized patients with schizophrenia at hospital. Participants completed the Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and STOP-Bang Questionnaire (SBQ) assessing risk of OSA. Logistic regression analysis was used to identify factors associated with OSA risk (SBQ score ≥3).ResultsOSA risk was identified in 236 participants (53.5%). Each 1-cm increase in waistline was associated with an 8% increased risk of OSA (OR = 1.08), and each 1-point increase in insomnia severity score was associated with a 9% increased risk (OR = 1.09).ConclusionsOver half of patients with chronic schizophrenia were at elevated risk for OSA, with insomnia severity and central obesity as the main correlates. Early screening, ongoing monitoring, and collaboration with mental health professional staff are essential for timely intervention, tailored care, and health promotion.

ObjectiveHuman flourishing (HF) has received increasing attention in the academic literature as a common goal towards which all strive. Many individuals are involved in a religious community or practice other forms of religious involvement, which they believe leads to a flourishing life. This general review examines the research exploring the association between religious involvement and HF.MethodsThe review examines the quantitative research published in peer-reviewed medical, nursing, psychiatric, public health, and social science journals that examines the connection between religious involvement and six widely acknowledged dimensions of HF and the four pathways that lead to it. The emphasis here is on previously conducted systematic reviews of the literature, while also providing more recent studies to support the findings from these earlier reviews.ResultsThere is a growing amount of research showing that religious involvement is related to various aspects of human flourishing and the pathways that lead to it. However, there are a number of studies that do not report these positive findings. Hypothetical mechanisms, limitations of this review, clinical implications, and future research needs are also provided.ConclusionsPrimary care physicians and mental health professionals may benefit from knowing about the research on this topic as they care for patients, many of whom are spiritual or religious.

ObjectiveAdvances in cardiac surgery and medicine have resulted in congenital heart disease (CHD) not being limited to children. CHD has been linked to emotional disorders, and untreated psychiatric disorders can worsen adult CHD patients' morbidity and mortality. This study sought to deepen the understanding of depression and anxiety in this population.MethodA cross-sectional study involving 378 adult outpatients with CHD aged 18 years or older was conducted. Cluster sampling was performed at cardiac center clinics in Riyadh, Saudi Arabia, and data were collected through questionnaires that included demographic information, the Generalized Anxiety Disorder Scale (GAD-7), and the Patient Health Questionnaire (PHQ-9), both of the latter validated in Arabic. Clinical characteristics were assessed using physician-rated New York Heart Association (NYHA) functional class for CHD.ResultsDemographic findings revealed a diverse population with the majority aged 18-24 (56.9%), 52.6% women, and 97.1% Saudi nationals. The clinical characteristics of CHD patients indicated that 63.2% were classified as NYHA Class I and 54.0% had simple CHD. A total of 14.6% of participants reported moderate or severe anxiety and 18.3% indicated moderate or severe depression. Significant associations were found between demographic factors and PHQ-9 and GAD-7 scores. Higher PHQ-9 scores were associated with age ≥35, female gender, and NYHA Class II-IV. Similar associations were observed for GAD-7 scores.ConclusionsDepression and anxiety symptoms were relatively common in this population, underscoring the need for comprehensive mental health support for adult patients with CHD. The association between negative emotions and certain demographic and clinical factors emphasizes the importance of providing personalized care to these patients.

ObjectiveInternet use had been correlated with depression previously. But the association between dynamic changes in internet use status and depression remains unclear. Therefore, the objective of this study was to explore whether changes in internet use status could affect the risk of depression.MethodAll the data were from China Health and Retirement Longitudinal Study (CHARLS). We selected wave 3 (2015) and wave 4 (2018) as the baseline and dynamic changes analyses, respectively. 11 335 participants were included. Internet use was assessed by questionnaire, and depression was assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). Multivariable logistic regression models were employed to assess the association of internet use status and its dynamic changes with risk of depression.ResultAfter adjusting for potential confounders, baseline internet use was negatively associated with risk of developing depression. After 2-year follow-up, compared with those who didn't use the internet in either 2015 or 2018 (non-users), people who ever used (OR = 0.81, 95% CI = 0.58-0.98) or continuously used the internet (OR = 0.64, 95% CI = 0.51-0.82) demonstrated a lower risk of incident depression. Moreover, the risk of the depression significantly declined when the offline individuals commenced using the internet (OR = 0.66, 95% CI = 0.55-0.79).ConclusionInternet use and initiation of Internet use were associated with reduced risk of developing depression in middle aged and older Chinese adults.

ObjectiveHead injury often causes depression, yet risk factors remain poorly understood. Muscle mass, linked to metabolic and neuroendocrine functions, may influence depression among adults with prior head injury and loss of consciousness (DPHI-LOC), but evidence is lacking.MethodsA cross-sectional analysis was conducted using data from the 2011-2014 National Health and Nutrition Examination Survey. The Appendicular Skeletal Muscle Mass Index (ASMI) was used to quantify muscle mass, and depressive symptoms were measured by the 9-item Patient Health Questionnaire (PHQ-9). Weighted multivariate logistic regression and propensity score matching (PSM) were used to evaluate associations between low muscle mass and DPHI-LOC, adjusting for demographic, socioeconomic, and clinical confounders. Subgroup analyses and interaction tests examined effect modifications across strata.ResultsAmong 2361 adults with head injuries, 232 (8.8%) were reported with DPHI-LOC. Low ASMI was independently associated with an elevated DPHI-LOC risk (adjusted OR = 2.35, 95% CI = 1.24∼4.46, P = 0.020). PSM analysis confirmed a 2.82-fold increased likelihood of depression in participants with low muscle mass (95% CI: 1.54∼4.09, P = 0.007). Subgroup analyses demonstrated that there were no significant effect modifications.ConclusionReduced muscle mass is a significant correlate of DPHI-LOC. These findings suggest that preservation of muscle mass may help to mitigate risk of depression after head injury.

ObjectivesTo assess the efficacy of escitalopram combined with quetiapine vs quetiapine alone in the treatment of depressive episodes of bipolar disorder (BPD).MethodsEighty-eight hospitalized patients with a BPD depressive episode were recruited into the study. All patients were randomized to a control group (n = 44) or the intervention group (n = 44). Members of the control group received quetiapine fumarate alone, with an initial dose 50 mg twice/day; the dose was increased by 50-100 mg daily until 300-600 mg/d was reached. The treatment group received quetiapine at the same doses plus escitalopram, with the initial dose of escitalopram 10 mg/d, adjusting the dose to 20 mg/d after 1 week. Both groups were treated for 8 weeks. Scores on the Hamilton Depression Scale (HAMD) and Young Mania Rating Scale (YMRS), along with levels of IL-6, IL-1β, MIF, SOD, CAT, MDA and GSH-Px, were compared between groups.ResultsAmong those in the intervention group, 88.6% of participants experienced a 50% or greater reduction in HAMD score compared to 70.5% in the control group (P < .05). Participants in the intervention group also experienced a significantly greater reductions in IL-6, IL-1β, MIF and MDA levels (P < .05), and a significant increase in SOD, CAT and GSH-Px levels compared to the control group (P < .05).ConclusionEscitalopram oxalate combined with quetiapine is more effective than quetiapine alone in the treatment of patients with bipolar depressive episodes. This combination can effectively improve the symptoms of depression, inhibit the body's inflammatory response, regulate the state of oxidative stress, and does not increase the risk of mania.

ObjectivePornography use can become addictive when a person loses control of watching sexual materials, such as sex graphic images and movies, and is unable to stop doing so despite negative consequences. Pornography addiction is a disorder that can impair mental health, behavior, and performance. The purpose of this study was to determine the prevalence and correlates of problematic pornography use among medical students in Egypt.MethodsThis cross-sectional study included 614 undergraduate medical students selected from each of the 6 academic years at a faculty of medicine in Egypt. The short version of the problematic pornography consumption scale (PPCS-6) was used to determine problem pornography use. Sociodemographic information and academic performance data were collected, and the Depression Anxiety Stress Scale-21 (DASS-21) was administered to assess depression, anxiety, and stress symptoms.ResultsNearly one-quarter (23.3%) of students had problematic pornography use. Problematic pornography use was associated with older age and male sex. Students with problematic pornography use reported fewer hours studying and had lower test scores in the previous year than those without problematic pornography use. Medical students with problematic pornography had significantly higher levels of depression, anxiety and stress symptoms compared to those without.ConclusionsProblematic pornography use is a common problem among medical students at a university in Egypt, is present in nearly one-quarter of students, and is significantly associated with older age, male sex, and depression, anxiety, and stress symptoms, as well as poorer academic performance.

ObjectiveTo evaluate psilocybin's efficacy in reducing depressive and anxiety symptoms in cancer patients based on randomized controlled trials (RCTs).MethodsThis systematic review and network meta-analysis (NMA) followed PRISMA and Cochrane Handbook guidelines. PubMed, Embase and Cochrane Library data up to July 2024 were analyzed. Two RCTs met the inclusion criteria. Changes in Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) scores were assessed on day 1 and on 2-week follow-up. The risk of bias was evaluated with the Cochrane Risk of Bias Tool 2.0.ResultsPsilocybin significantly reduced BDI scores at day 1 post-administration (MD = 2.26; P = 0.01), though effects were not sustained at 2 weeks. STAI state scores showed substantial reductions at both day 1 (MD = 11.52; P < 0.001) and 2 weeks (MD = 12.66; P < 0.001). STAI trait scores also improved on both day 1 and day 14. The highest psilocybin dose (0.3 mg/kg) was the most effective, with SUCRA values of 87.81% (BDI), 91.58% (STAI state), and 94.2% (STAI trait).ConclusionsFindings suggest psilocybin may rapidly reduce depressive and anxiety symptoms in cancer patients, but methodological limitations, including the small number of trials, necessitate cautious interpretation. Larger, high-quality RCTs are needed to verify its clinical potential.