Alpha psychiatry最新文献

Objective: Adverse sleep and wake patterns are associated with physical health complaints, including metabolic disorders. The aim of this study was to evaluate the relationship between delayed sleep phase syndrome (DSPS) and napping during the day with metabolic syndrome (MetS).

Methods: This study was conducted on 10 065 participants aged 35-65 years using baseline data from the Ravansar Non-Communicable Disease (RaNCD) cohort study. Delayed sleep phase syndrome was evaluated through a clinical interview to rule out the possibility that the sleep complaints were a result of psychiatric disorders. Logistic and linear regression models were used to determine associations.

Results: The severity of MetS was found to be higher in men, older age groups, married people, subjects with a lower education level, urban residents, smokers, people with low physical activity, and DSPS. In the fully adjusted model, the odds of having MetS were 26% (95% Confidence interval (CI): 1.08, 1.48) higher in those with DSPS compared to those without DSPS. Additionally, the odds of MetS were 18% higher in people who napped less than 1 hour per day, 26% higher in those who napped 1-2 hours per day, and 21% higher in those who napped over 2 hours per day, compared to non-nappers. All of these associations were statistically significant. The odds of having the severity of MetS were significantly 6% (95% CI: 0.01, 0.12) higher in those with DSPS compared to those without DSPS.

Conclusion: The findings of this study indicate that DSPS and daytime napping are associated with an increased risk of MetS. Interventions aimed at improving sleep quality are recommended as potential strategies to help reduce the risk of developing MetS.

Objective: Overweight and obesity are health issues that are increasing worldwide. Patients with severe mental illness are particularly vulnerable for various reasons, including the intake of weight gain-associated drugs. In this pilot study, we targeted eating behavior as a predictor for medication-induced weight gain and developed a module of a prevention program ("Eating More Consciously") to be evaluated by psychiatric inpatients.

Methods: Thirty-three patients participated in a behaviorally oriented group therapy program with 2 modules of 120 minutes each and weekly follow-up measurements over 4 weeks. Measures included weight, laboratory parameters, the German versions of the Three-Factor Eating Questionnaire (Fragebogen Essverhalten; FEV) and the Food Craving Inventory (FCI) as well as a questionnaire on the implementation of the strategies in everyday life.

Results: Thirty-three participants completed both modules and felt that they had benefited from the module "Eating More Consciously". Fragebogen Essverhalten domain "cognitive restraint" scores increased significantly throughout the study (P = .039), and the FCI sum score decreased significantly (P = .003).

Conclusion: We propose that the "Eating More Consciously" module is a promising approach to behavioral intervention in weight management in patients with severe mental illness. Prospective randomized controlled studies with a larger sample and a longer follow-up are needed.

[This corrects the article DOI: 10.5152/alphapsychiatry.2024.241613.].

Objective: In order to determine whether intermittent theta-burst stimulation (iTBS) is a viable adjunct treatment for schizophrenia, a meta-analysis of double-blind, randomized clinical trials (RCTs) was performed.

Methods: Four independent researchers extracted and synthesized data from RCTs on adjunctive iTBS for patients suffering from schizophrenia. RevMan 5.3 software was used to calculate risk ratios (RRs) and standardized mean differences (SMDs) along with their 95% confidence intervals (CIs).

Results: Fifteen RCTs involving 671 patients with schizophrenia were included. Adjunctive iTBS was significantly superior to sham interventions for improvement in overall psychopathology (SMD = -0.75, 95% CI: -1.10, -0.41, I ² = 64%, P < .0001), negative symptoms (SMD = -0.76, 95% CI: -1.18, -0.35, I ² = 78%, P = .0003), and general psychopathology (SMD = -0.51, 95% CI: -0.88, -0.14, I ² = 71%, P = .007), though no significant group difference was found regarding positive symptoms. Adjunctive iTBS also demonstrated superiority over control treatments in improving cognitive functions as measured by the Spatial Span Test (SMD = 0.83, 95% CI: 0.16, 1.49, I ² = 73%, P = .02) and Montreal Cognitive Assessment (SMD = 0.49, 95% CI: 0.11, 0.88, I ² = 0%, P = .01). Discontinuation rates (RR = 0.92, 95% CI: 0.57, 1.50, I ² = 0%, P = .75) and adverse events were comparable between groups.

Conclusion: The use of iTBS in patients with schizophrenia appears to be effective in improving psychiatric symptoms and cognitive function. To substantiate these preliminary findings, future research involving larger participant cohorts is warranted.

Objective: The aim of the study was to investigate the therapeutic effects of modified electroconvulsive therapy (MECT) in combination with risperidone tablets and psychotherapy in the treatment of patients with treatment-resistant schizophrenia (TRS).

Methods: Patients with TRS admitted to the psychiatric department of our hospital between January 2018 and December 2019 were selected as study participants. They were randomly divided into a control group and a study group, with the control group receiving risperidone tablets and psychotherapy, and the study group undergoing MECT as well as the control group treatment. The mood scores, efficacy, and side effects of the 2 groups were compared.

Results: After treatment, the Hamilton Anxiety Rating Scale (t = 2.316, P = .021) and Hamilton Depression Rating Scale (t = 2.919, P = .013) scores of the study group were significantly lower than those of the control group. The overall remission rate in the study group was 96.3%, which was higher than that of the control group (χ ² = 9.319, P = .007). The Positive and Negative Syndrome Scale (t = 8.126, P = .003), Traumatic Exposure Severity Scale (t = 13.210, P = .002), and Brief Psychiatric Rating Scale (t = 6.412, P = .001) scores were significantly lower in the study group than in the control group. The Wechsler Memory Scale score was higher in the study group than in the control group (t = 3.971, P = .002).

Conclusion: The use of MECT in combination with risperidone tablets and psychotherapy can effectively improve patient mood, increase efficacy, reduce adverse effects, promote memory recovery, and shorten recovery time in patients with TRS.

Objective: To conduct a meta-analysis on the connection between vitamin D deficiency and perinatal depression.

Methods: A comprehensive literature search was conducted across several databases, including PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, and VIP database. Two reviewers independently assessed the risk of bias in articles using the Cochrane collaboration's tool, with analysis performed via RevMan software.

Results: After reviewing major databases, 13 studies were included. Three studies assessed prenatal depression and vitamin D levels, showing significantly lower levels in the depression group compared to controls (Standardized Mean Difference [SMD] = -0.41, 95% Confidence Interval [CI] -0.57 to -0.25) with minimal heterogeneity, thus a fixed effects model was used. Another three studies explored postpartum depression and vitamin D, revealing considerable heterogeneity (I ² = 96%, P < .01), leading to the use of a random effects model; these indicated much lower vitamin D levels in the depression group (SMD = -1.62, 95% CI -2.62 to -0.62). Seven studies examined the link between postpartum depression and vitamin D deficiency, again showing significant heterogeneity (I ² = 92%, P < .01) and lower vitamin D levels in depressed women (SMD [Standardized Mean Difference] = 2.28, 95% CI 1.60-3.25), with no significant publication bias detected.

Conclusion: Reduced vitamin D levels are significantly associated with the incidence of perinatal depression. Pregnant women with reduced vitamin D levels have a relatively higher risk of depression. This signifies that vitamin D levels may figure prominently in maintaining maternal mental health.

Objective: Patients with depression often experience cognitive impairments. Cognitive rehabilitation, as an adjunctive intervention, may help to improve symptoms and restore functions in these patients. This study explores the effectiveness of cognitive rehabilitation in improving symptoms and restoring cognitive functions in patients with depression.

Methods: The following databases were systematically searched for relevant randomized controlled trials (RCTs): PubMed, Embase, and the Cochrane Central Register of Controlled Trials. Two reviewers independently screened the studies. The search was conducted from the inception of the databases to April 10, 2024. Standardized mean differences (SMDs) with 95% CIs, confidence interval were calculated using RevMan v. 5.3 software, and heterogeneity was assessed using Cochran's Q test and the I ² statistic.

Results: A total of 14 RCTs involving 700 patients were included in this meta-analysis. Compared with the control group, there was no significant difference in the severity of depression after cognitive rehabilitation intervention, with a pooled SMD of -0.14 (95% CI: -0.32 to 0.05; P = .15; I²  = 30%). Among the 4 studies reporting attention-related data, cognitive rehabilitation significantly improved attention function in patients with depression compared with the control group, with an SMD of -0.63 (95% CI: -0.99 to -0.27; P < .001; I² = 0%). In 6 studies, data showed significant improvement in verbal learning ability in patients with depression after cognitive rehabilitation intervention, with an SMD of -0.33 (95% CI: -0.60 to -0.05; P = .02; I² = 48%). Executive function outcomes were reported in 6 studies, whereas working memory outcomes were reported in 7 studies, both before and after the intervention. No significant differences were observed between the groups, with SMDs of -0.45 (95% CI: -1.09 to 0.19; P = .17; I²  = 78%) in executive function and -0.38 (95% CI: -0.82 to 0.07; P = .10; I² = 67%) in working memory post-intervention. Subgroup analysis suggested that cognitive rehabilitation training had a close to statistically significant improvement effect on depression severity in European regions, whereas no significant impact was observed in other regions.

Conclusion: Cognitive rehabilitation shows certain value in improving attention and verbal learning in patients with depression as an adjunctive treatment, but its effectiveness in improving depressive symptoms, executive function, and working memory remains inconclusive. Future large-sample RCTs are needed to further explore this aspect.

Objective: The objective is to investigate the situation and risk factors of depression in aged, hospitalized patients with chronic heart failure (CHF).

Methods: A total of 196 aged CHF patients admitted to Xuanwu Hospital from May 2022 to March 2024 were consecutively selected. Information such as demographics, comorbidities, old-age hospitalization assessment results, and admission test results was collected. Differences were found between the patients admitted with CHF and depression and those without depression. Independent predictors of depression in aged, hospitalized patients with CHF were identified using logistic regression analyses. The sensitivity and specificity of age, frailty score, and New York Heart Association (NYHA) classification to evaluate the occurrence of depression were examined by calculating the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.

Results: Increased age [OR (Odds Ratio) = 1.132, (95% CI [Confidence Interval], 1.050-1.221), P = .001], higher frailty score [OR = 8.324, (95% CI, 4.233-16.368), P < .001], and higher NYHA classification [OR = 3.806, (95% CI, 1.864-7.773), P < .001] were independent predictors of depression in aged CHF hospitalized patients. The best indicators for the occurrence of depressive symptoms were age of 75 years, a score of 2 for frailty, and an NYHA classification of III. The AUCs for age, frailty score, and NYHA classification were 0.764, 0.876, and 0.707, respectively.

Conclusion: Clinical assessment of depression is necessary for aged, hospitalized CHF patients. Patients over 75 years old, with a frailty score of at least 2, and an NYHA classification of III or IV are more prone to depression, which requires attention.