International Journal of Psychiatry in Medicine最新文献

ObjectiveIron deficiency anemia is one of the most common nutritional disorders in the world, particularly among women and children. This condition, caused by insufficient iron levels in the body, not only affects physical performance and reduces energy but can also have a significant impact on mental health. This study compared the general health and mental health of individuals with iron deficiency anemia with that of healthy individuals.MethodHealthy individuals and those with iron deficiency anemia were assessed at the Aramesh Pathobiology and Genetics Laboratory in Tehran, Iran. Participants were a convenience sample of 170 healthy individuals and 170 individuals with iron deficiency anemia. Data were collected using the General Health Questionnaire and the Irritability Questionnaire.ResultsIndividuals with iron deficiency anemia scored higher than healthy individuals on somatic symptoms, anxiety and insomnia, social dysfunction, and depression. Irritability was also significantly higher in this group, indicating a possible negative impact of iron deficiency anemia on emotional regulation. Furthermore, irritability and social dysfunction strongly predicted iron deficiency anemia.ConclusionIron deficiency anemia increases the risk of symptoms of mental disorder, including depression, anxiety, irritability, insomnia, social dysfunction, as well as symptoms of physical health problems.

ObjectiveEmerging evidence suggests that serum uric acid (SUA) can modulate depressive symptoms, potentially via mechanisms involving oxidative stress. However, whether the serum uric acid/creatinine ratio (SUA/Cr)-a biomarker reflecting net uric acid production-is linked to depressive symptoms in middle-to-late life populations remains unknown.MethodsLongitudinal and cross-sectional analyses were conducted utilizing nationally representative samples from two countries: the China Health and Retirement Longitudinal Study (CHARLS) for longitudinal assessment and the U.S. National Health and Nutrition Examination Survey (NHANES) for cross-sectional evaluation. Multivariable Cox and logistic regression analyses were employed to examine the relationship between the SUA/Cr and depressive symptoms. Dose-response relationships were modeled using restricted cubic splines (RCS), while sensitivity analyses assessed the stability of results. ResultsFrom CHARLS (N = 4317), multivariable Cox regression revealed an inverse relationship between SUA/Cr and depressive symptoms (P-linearity<0.05), with each 1-unit increase linked to a 3% lower risk (HR = 0.97, 95% CI = 0.94-0.99). Q4 showed reduced risk vs Q1 (HR = 0.87, 95% CI = 0.77-0.97). NHANES analysis of cross-sectional data (N = 18 677) confirmed this inverse association (P- linearity<0.05), with a 6% lower odds of significant depression per 1-unit SUA/Cr increase (OR = 0.94, 95% CI = 0.87-1.03). Q3 and Q4 had significantly lower odds vs Q1 (OR = 0.78, 95% CI = 0.64-0.95, and OR = 0.79, 95% CI = 0.65-0.98, respectively). RCS curves confirmed dose-response relationships in both cohorts. Findings remained consistent in sensitivity analyses.ConclusionDepressive symptoms in middle-to-late adulthood were found to be negatively correlated with SUA/Cr levels in longitudinal and cross-sectional analyses. These findings suggest that SUA/Cr levels may function as a biological indicator to facilitate early detection and proactive intervention for depressive disorders.

ObjectiveTo present a case of probable autoimmune encephalitis initially misdiagnosed as a primary psychiatric disorder.MethodA case of probable autoimmune encephalitis presenting with catatonia in a young woman 6 months post-partum is described in this article.ResultsThe patient was admitted to an outside hospital, diagnosed with a primary psychiatric condition, and sent to psychiatric inpatient, where she was denied admission due to labile hypertension. After admission to the medical service (and ICU), she responded to a lorazepam challenge, and made a complete recovery within several weeks after combination treatment with IV methylprednisolone, IV immunoglobulin (IVIG), and rituximab.ConclusionAutoimmune encephalitis should be suspected in patients presenting with labile vital signs, family history of autoimmunity, and new psychosis without prior history of psychiatric problems. Other important diagnostic considerations include neuroleptic malignant syndrome, substance-induced psychosis, or catatonia secondary to post-infectious immune-mediated encephalitis. While a first psychotic break should always be considered, the presence of autonomic instability, catatonia, seizures, or dyskinesias in a young woman postpartum should prompt a thorough medical and neurological work-up.

ObjectiveTo examine the effects of metabolic and bariatric surgery on physical outcomes, mental health, and quality of life (QOL) among obese patients in China.MethodsIncluded were 182 patients who underwent laparoscopic sleeve gastroplasty (LSG, a form of metabolic and bariatric surgery). Effects on postoperative weight, waist circumference, hip circumference, BMI, and the percentage of excess weight loss (%EWL) were observed during the 12 months after surgery. Changes in physical comorbidities were also determined. Anxiety symptoms were assessed by the Self-rated Anxiety Scale (SAS); depressive symptoms by the Self-rated Depression Scale (SDS); and QOL by the SF-36 scale. Assessment points were at baseline and 3, 6, and 12 months after surgery.ResultsSignificant improvements were observed in weight, waist circumference, hip circumference, BMI, and %EWL after surgery (P < 0.05). The remission rates for hypertension, diabetes, fatty liver, hyperlipidemia, and obstructive sleep apnea-hypopnea syndrome (OSAHS) were 89.5%, 95.5%, 82.6%, 81.7%, and 61.7%, respectively, 1 year after surgery (P < 0.05). Anxiety (SAS) and depressive (SDS) symptoms decreased significantly over time (P < 0.05). SF-36 scores in the physical and psychological domains increased significantly (P < 0.05). However, overall SF-36 scores were higher at 6 months compared to 12 months (P < 0.05).ConclusionLaparoscopic sleeve gastroplasty results in significant weight loss in the short term, which can improve anxiety symptoms, depressive symptoms, and QOL in obese patients. However, some social and psychological improvements appear to plateau at 6 months following surgery.

ObjectiveThis study investigated ADHD comorbidity and clinical features, including hyperfocus, in women with depressive or anxiety disorders, addressing the diagnostic complexities arising from symptom overlap and the underdiagnosis of ADHD in this population.MethodsFemale patients from outpatient psychiatric clinics (n = 170) were assessed using the Beck Depression Inventory and Beck Anxiety Inventory. Participants meeting threshold scores underwent further evaluation with the Wender-Utah Rating Scale, Hyperfocus Scale, and Adult ADHD DSM-IV-Based Diagnostic Screening Scale, complemented by structured clinical interviews.ResultsADHD was identified in 19.6% (n = 33) of patients, 45.5% (n = 15) of whom were previously undiagnosed. ADHD was most prevalent in patients with social anxiety disorder (46.4%) and double depression (40.6%). In non-ADHD participants, attention deficit correlated positively with depression (r = 0.236, p = 0.005), hyperactivity with anxiety (r = 0.187, p = 0.029), and hyperfocus with ADHD scores (r = 0.434, p < 0.001; r = 0.292, p = 0.001); no such correlations were seen in the ADHD group.ConclusionADHD is common and frequently overlooked in women presenting with depression or anxiety. While hyperfocus is a relevant clinical feature, it is not diagnostic alone and correlates with ADHD symptoms in the absence of ADHD. Clinicians should conduct thorough screenings for ADHD and carefully interpret hyperfocus within the broader clinical context to ensure accurate diagnosis and timely, appropriate treatment.

ObjectivePatients with obsessive-compulsive disorder (OCD) may have changes in their hypothalamic-pituitary-adrenal axis, and as a result, have increased secretion of adrenocorticotropic hormone and cortisol and reduced secretion of melatonin. Examination of pineal gland volumes in patients with OCD compared to healthy controls, thus, is an important consideration and the focus of this study.MethodsA total of 20 patients with OCD and 20 healthy controls were enrolled in this study. Demographic and clinical characteristics of participants were assessed, and structural magnetic resonance imaging was performed.ResultsPatients with OCD had a statistically significant smaller pineal gland volumes compared to healthy controls.ConclusionIn this pilot study, patients with OCD exhibited smaller pineal gland volumes compared to healthy control subjects. While this finding suggests a potential link between the pineal gland and OCD pathophysiology, further research with larger sample sizes and measurement of hormonal changes is necessary.

ObjectiveFunctional seizures (FS) are a highly debilitating symptom of functional neurological disorder (FND). FS require a multi-disciplinary approach to treatment because the patient's initial presentation may be to neurology, emergency medicine, or primary care, and the treatment consists of psychotherapy. People with FS commonly experience severe childhood trauma, particularly sexual trauma. The present study examined associations between reported trauma and maladaptive coping mechanisms in the FS population.MethodsThis retrospective, observational study reports on 137 patients enrolled in the FS Clinic at the University of Colorado between March 2020 - March 2021. Linear regression was used to examine associations between self-reported childhood sexual and violent trauma and maladaptive coping mechanisms of self-blame and disengagement based on the Brief COPE. A quantile regression was generated for each of these outcomes.ResultsResults indicated that violent trauma and sexual trauma were reported by 47.5% and 61.6% of the sample, respectively. Of those exposed to violent trauma, 27.2% perceived it as extremely severe while 43.4% of those exposed to sexual trauma perceived it as extremely severe. Quantile regression for self-blame and disengagement showed significance for the 25th percentile of those who experienced violent trauma. Self-blame was significantly associated with the 50th and 75th percentile of those exposed to sexual trauma.ConclusionsThese findings supports the value of identifying trauma experienced by individuals with FS as it is associated with specific coping mechanisms that may affect treatment. Identifying prior trauma and current coping responses may assist in individualizing care for people with FS.

ObjectiveExisting studies on the effects of physical activity on cognitive function have predominantly focused on pre- or post-exercise effects, leaving a gap in understanding with regard to immediate cognitive impacts during physical exertion. Understanding cognitive performance during activity could have significant implications for improving productivity and the development of therapeutic strategies.MethodsThis study examined the relationship between heart rate and cognitive performance, specifically attention, using the D2 attention test among 32 adolescents aged 12-18 years. Participants underwent attention assessments at rest and while moving at target heart rates of 100 bpm, 120 bpm, and 140 bpm. The influence of body mass index (BMI) and sleep quality on attention was also analyzed.ResultsA positive correlation between heart rate and attention was observed (r = 0.39, P < .005), indicating enhanced cognitive performance with increased heart rate. Furthermore, a negative correlation was found between BMI and attention (r = -0.37, P = .039) and a positive correlation was found between sleep quality and attention (r = 0.66, P = .014).ConclusionThese findings suggest that moderate physical activity can enhance attention, which could inform the design of educational, therapeutic, and occupational strategies. Future research should explore the generalizability of these findings across different cognitive domains, age group, and setting.

ObjectiveInsomnia is characterized by difficulty falling asleep, staying sleep, or both. Aromatherapy is a commonly used complementary and alternative medicine practice by persons with insomnia. Previous studies have shown that use of chamomile oil during massage therapy improves the quality of sleep (QoS). However, to our knowledge, no randomized controlled trials have examined the effects of chamomile oil inhalation on the treatment of insomnia. The present study evaluated the effect of chamomile oil inhalation on QoS and insomnia severity in persons with insomnia.MethodsA total of 80 participants ages 18-35 with insomnia were randomly assigned to aromatherapy group (AG; n = 40) or a control group (CG; n = 40). Those in the AG group received chamomile oil inhalation, while those in the CG group engaged in their normal routine for 10 minutes a day, daily for 15 days. The Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were administered before and after the intervention.ResultsWithin-group analysis showed a significant reduction both in PSQI and ISI scores among those in the AG (P < 0.001 for both scores), whereas the CG reported a significant reduction in PSQI score (P = 0.033) and no significant changes in ISI score (P = 0.068). The between-group analysis after the intervention demonstrated a significant reduction in PSQI and ISI scores in the AG group (P < 0.001 for both) compared to the CG group. No participant in either group reported adverse events during or after the study.ConclusionFifteen days of chamomile oil inhalation before bedtime reduced insomnia severity and enhanced the quality of sleep for young adults suffering from insomnia. Further studies are needed to replicate the results of this study using an active control group.