Alpha psychiatry最新文献

Schizophrenia (SCZ) is a debilitating, chronic mental disorder with an elusive etiology that significantly impacts the life expectancy of affected individuals. Metabolic syndrome (MetS) is a condition characterized by a combination of factors that increase the risk of cardiovascular diseases. MetS is more prevalent in individuals with SCZ and is a major factor that contributes to their reduced lifespan. This review scrutinizes the biological factors that predispose patients with SCZ to MetS, among which, genetic predisposition, dietary and lifestyle modifications, and the use of antipsychotic drugs (APs) play a significant role. The metabolic side effects of APs have been well studied. While studies have shed light on potential interventions to manage MetS in patients with SCZ, identifying precise biological targets to treat SCZ remains challenging. Therefore, further studies are warranted to enhance our comprehension of the intricate mechanisms underlying the susceptibility of patients with SCZ to MetS. These studies will be crucial in developing effective, targeted therapeutic strategies to treat MetS in this vulnerable population.

Objective: The Coronavirus disease 2019 (COVID-19) pandemic caused a range of mental health problems, particularly self-harm. Lockdowns are the usual methods of responding to these public health emergencies. However, the effect of the COVID-19 lockdown on self-harm remains poorly characterized. This study aimed to investigate the influence of the COVID-19 pandemic on the incidence of self-harm. The findings may inform future policy development and strategies for managing pandemic-related mental health challenges.

Methods: A meta-analysis was conducted using several database searches: APA PsycINFO, Embase, PubMed, Web of Science, CNKI, and Wan Fang. Published studies with data on the incidence of self-harm during visits to medical institutions, before and during the COVID-19 pandemic, were included. The pooled risk ratio (RR) value of self-harm incidence variation before and during the COVID-19 lockdown period, expressed as the comparison of clinical institution visits before and during the pandemic, was calculated.

Results: Fifteen retrospective cohort studies with observational designs involving 253,600 participants were included. The pooled RR value of self-harm incidence variation was 1.386 (95% confidence interval (CI), 1.205-1.595, I² = 58.9%, p = 0.002). The subgroup analysis showed that "emergency department type" (p = 0.004) and "mean age of the sample" were the sources of the RR values' heterogeneity (p = 0.026).

Conclusions: Our findings suggest that the lockdown during the COVID-19 pandemic was a risk factor for self-harm. Therefore, special attention should be paid to individuals visiting the emergency department and the middle-aged and elderly populations.

The prospero registration: This study was registered in PROSPERO (CRD42023373026), https://www.crd.york.ac.uk/PROSPERO/view/CRD42023373026.

Background: The Montreal Cognitive Assessment Basic scale (MoCA-B) is more sensitive than the Mini-Mental State Examination (MMSE) for detecting mild cognitive impairment due to Alzheimer's disease (AD). To explore the diagnostic efficacy of the Chinese version of the MoCA-B against the MMSE for post-stroke cognitive impairment (PSCI).

Methods: Eighty four patients with acute cerebral infarction were grouped into a post-stroke cognitive normal (PSCN) or a PSCI group based on their scores on the Clinical Dementia Rating scale (CDR), the gold standard for diagnosing PSCI. They were evaluated by using the MMSE and MoCA-B scales, then the area under the receiver operating characteristic (ROC) curve (AUC) was used for evaluation.

Results: Most factors of the MoCA-B were significantly different between the two groups, and the PSCN group completed the MoCA-B faster (p < 0.05). The AUC analysis showed that for the MoCA-B with a cut-off total score of 23, sensitivity = 85.71%, specificity = 61.22%, Youden's J Index = 0.469, and AUC = 0.832. For the MMSE with a cut-off total score of 25, sensitivity = 70.59%, specificity = 93.75%, Youden's J Index = 0.643, and AUC = 0.885. The AUC of the MMSE was higher than that of the MoCA-B (p > 0.05). The MoCA-B had greater sensitivity and negative predictive value than the MMSE. When considering the cutoffs for identifying mild cognitive impairment (MCI) across different education levels, the MoCA-B had a higher positive rate for PSCI identification (51.2% vs 25%, p < 0.001), indicating that the MoCA-B is suitable for identifying PSCI.

Conclusion: The MoCA-B demonstrates higher sensitivity and negative predictive value compared with the MMSE in the screening of post-stroke cognitive impairment patients.

Objective: To explore the effects of smartphone-based hospital-family transitional care on symptom burden and quality of life in elderly patients with depression.

Methods: This study retrospective analyzed the clinical data of 168 elderly patients with depression admitted to our hospital from January 2022 to January 2024. A total of 79 patients were included in the reference group (routine transitional management), and 89 subjects were included in the observation group (smartphone-based hospital-family transitional care). The symptom burden and quality of life in both groups before and after management were compared. The main statistical methods used in this study were the chi-squared test and the Mann-Whitney U test.

Results: Before discharge, no significant difference existed in Geriatric Depression Scale (GDS) scores, P300 latency, P300 amplitude, Montreal Cognitive Assessment (MoCA) scores, and the scores of each domain in the World Health Organization Quality of Life (WHOQOL)-BREF between the two groups (all p > 0.05). After 5 months, the observation group demonstrated a significantly lower GDS score (p = 0.016), shorter P300 latency (p < 0.001), higher P300 amplitude (p < 0.001), higher MoCA score (p = 0.001), and significantly higher scores in physiological, psychological, and environmental domains than the reference group (p < 0.001), with no significant difference in social relation domain (p > 0.05).

Conclusions: Smartphone-based hospital-family transitional care can improve the symptom burden, cognitive function, and quality of life of elderly patients with depression.

Background: Understanding gene expression and functional connectivity (FC) changes in depressed patients with anxiety can help develop personalized therapies. Herein we examine the link between transcriptome data and FC differences in patients with major depressive disorder with significant anxiety (MDD/ANX+) and patients with major depressive disorder without significant anxiety (MDD/ANX-).

Methods: We compared the FC between the MDD/ANX+ group (n = 294) and the MDD/ANX- group (n = 218) to identify FC differences at both edge-based and network levels. Using the Allen Human Brain Atlas, we performed partial least squares regression analysis to identify genes associated with the observed FC disparities, followed by a functional enrichment analysis.

Results: The results from both edge-based and network-level FC analyses consistently indicated significantly increased FC between the subcortical network (SC) and visual network, as well as between the SC and dorsal attention network, in the MDD/ANX+ group compared with the MDD/ANX- group. Additionally, transcriptome-neuroimaging correlation analysis revealed that the expression of 1066 genes was spatially correlated with the FC differences between the MDD/ANX+ and MDD/ANX- groups. These genes were enriched in translation at synapses and adenosine triphosphate (ATP) generation.

Conclusions: Our results indicate that gene expression variations in synaptic translation and ATP generation may affect FC and anxiety risk in MDD patients.

Objective: To investigate the risk factors for relapse among elderly schizophrenia patients undergoing maintenance phase treatment, aiming to offer insights for relapse prevention in this population.

Methods: A survey was conducted of elderly schizophrenia patients in the maintenance phase who attended outpatient clinics at a specialized psychiatric hospital from October, 2021 to September, 2023. The survey included both general and clinical data. Univariate analysis and multivariate non-conditional logistic regression analysis were conducted to identify independent risk factors for relapse in elderly schizophrenic patients undergoing maintenance phase treatment. A receiver operating characteristic (ROC) curve was drawn based on logistic regression results and the area under the curve (AUC) was used to evaluate the predictive value of each risk factor for relapse studied in these patients.

Results: A total of 247 patients were collected, with 225 patients included in the analysis: 75 in the recurrence group and 150 in the non-recurrence group. Multivariate logistic regression analysis indicated: Irregular medication status (odds ratio (OR) = 3.302, 95% confidence interval (CI): 1.386-7.871), low exercise frequency (OR = 2.770, 95% CI: 1.141-6.726), family care points (OR = 0.647, 95% CI: 0.514-0.813), life event points (OR = 1.353, 95% CI: 1.194-1.533), and sleep duration (OR = 0.630, 95% CI: 0.504-0.788) as independent influencing factors for relapse during the maintenance phase of elderly patients with schizophrenia. The AUC for predicting relapse varied among these factors: Medication status (AUC: 0.660, 95% CI: 0.594-0.726), exercise frequency (AUC: 0.663, 95% CI: 0.599-0.727), family care (AUC: 0.691, 95% CI: 0.618-0.764), life events (AUC: 0.792, 95% CI: 0.731-0.853), and sleep duration (AUC: 0.789, 95% CI: 0.718-0.859). When considering all influencing factors, the AUC for predicting relapse during maintenance phase treatment of elderly patients with schizophrenia was 0.908 (95% CI: 0.867-0.949).

Conclusion: Medication status, exercise frequency, family care, life events and sleep duration emerged as independent influencing factors for relapse among elderly schizophrenia patients during maintenance phase treatment. Paying attention to these influencing factors simultaneously is suggested to prevent recurrence.

Objectives: This study aimed to establish the validity and reliability of a fear of failure scale for adolescents.

Methods: The study involved 279 secondary school students enrolled in the 2020-2021 academic year. Internal consistency, item-total score correlation, and split-half methods were used to determine reliability, while exploratory and confirmatory factor analyses were employed to determine validity.

Results: The two split-in-half method calculations found a Guttman Split-in-Half coefficient of 0.855 and a Spearman-Brown coefficient of 0.857. Cronbach's Alpha was 0.802 for the first half (items 1-9) and 0.774 for the second half (items 10-17). CFA analyses showed that a three-factor solution fit the data, but some goodness-of-fit indices fell below acceptable levels. To improve the model, error covariances of certain items were correlated based on modification indices. The final values were Minimum Discrepancy of Confirmatory Factor Analysis/Degrees of Freedom (CMIN/df) = 2.727, Goodness of Fit Index (GFI) = 0.911, Adjusted Goodness of Fit Index (AGFI) = 0.863, Comparative Fit Index (CFI) = 0.673, Root Mean Square Error of Approximation (RMSEA) = 0.079, χ² = 160.9, Degrees of Freedom (DF) = 59. Factor loadings ranged from 0.52 to 0.83 for the first factor, 0.68 to 0.85 for the second factor, and 0.55 to 0.84 for the third factor.

Conclusions: The fear of failure scale is a reliable and valid measurement tool. A review of the existing literature revealed a lack of scales that assess the physical, emotional, and thought dimensions of fear of failure among individuals aged 11-14 years. This gap underscores the potential for measurement-based research in this domain. Through this study, a valid and reliable scale was developed to evaluate fear of failure in adolescents within the 11-14 year-age range, thereby addressing this critical need.

Background: Borderline personality disorder (BPD) is a complex mental health condition characterized by instability in interpersonal relationships, affect regulation, and impulse control. A core feature of BPD is identity disturbance, marked by a persistently unstable self-image and sense of self. Despite clinical recognition, the precise nature of identity disturbance remains ambiguous, with no clear consensus on its specific manifestations and measurable parameters. With the scoping review projected in this protocol, we aim to define what has been said in the literature about identity disturbance, its types, and methods of measurement.

Study design: Scoping review protocol.

Methods: Included publications will comprise empirical and theoretical studies focusing on identity disturbance in individuals diagnosed with BPD. Databases will include PubMed, PsycINFO, Scopus, and Web of Science Core Collection, supplemented by Google for grey literature. Data will be screened by two reviewers and discrepancies will be resolved through discussion or a third reviewer if necessary. Extracted data will include study details, methodological data, definitions of identity, conceptualizations of identity disturbance, types of disturbance, and assessment tools.

Conclusions: The forthcoming results will have the potential to make significant contributions to both theoretical and empirical knowledge on identity disturbance in BPD. It is expected that the results of the review will help to inform and improve therapeutic strategies, enabling more tailored and effective interventions for BPD patients with identity disturbance.

Background: Intermittent Explosive Disorder (IED) is an impulse-control disorder characterized by the inability to control emotions and behaviors, resulting in behaviors that violate social norms and the rights of others. The IED Screening Questionnaire (IED-SQ) is a valuable tool that can quickly identify the presence of IED in adults by Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) criteria. This study evaluated a form of the IED-SQ that had been translated into Turkish, and investigated the reliability and validity of the Turkish version of the IED-SQ.

Methods: Seventy-one adult IED patients and 68 adult controls participated. The Barratt Impulsivity Scale (BIS-11), Minnesota Impulse Control Disorder Interview Scale (MIDI), Buss Perry Aggression Questionnaire (BPAQ), Symptom Checklist 90-Revised (SCL-90-R), Wender Utah Rating Scale (WURS), and IED-SQ were administered to the participants.

Results: The Cronbach's α coefficient of the IED-SQ was 0.74. The subscales of the BPAQ, including physical aggression, verbal aggression, hostility, and anger, along with the attention and non-planning impulsivity subscales of the BIS-11, were incorporated into the multivariate analysis to identify factors independently associated with the IED-SQ. According to the model, the correct classification percentage was found to be 95%.

Conclusions: This study demonstrated that the Turkish version of the IED-SQ is valid and reliable and can be used in clinical practices to identify the presence of IED.