Alpha psychiatry最新文献

Objective: The aim of this study was to develop and validate a machine learning model to predict the risk of comorbid depression in asthma patients.

Methods: We conducted a retrospective study of 2464 asthma patients with comorbid depression using National Health and Nutrition Examination Survey (NHANES) data. Feature selection was conducted using the Boruta algorithm and the Least Absolute Shrinkage and Selection Operator (LASSO). Eight machine learning algorithms, namely Decision Tree (DT), k-Nearest Neighbors (KNN), Light Gradient Booster Machine (LGBM), Logistic Regression (LR), Random Forest (RF), Support Vector Machine (SVM), eXtreme Gradient Boosting (XGBoost), and Multilayer Perceptron (MLP), were trained using 5-fold cross-validation methodology. Model performance was evaluated through various metrics such as area under the curve (AUC), accuracy, sensitivity, specificity, F1 score, and decision curve analysis (DCA). Interpretation was conducted using SHapley Additive exPlanations (SHAP) analysis, highlighting feature importance.

Results: The training set comprised 1724 participants, while the validation set included 740 participants, with a depression prevalence of 14.45%. Significant predictors identified included hypertension, chronic obstructive pulmonary disease (COPD), stroke, sleep questionnaire (SLQ) scores, smoking status, Poverty Index Ratio (PIR), and educational level. The XGBoost model demonstrated superior performance compared with alternative machine learning (ML) algorithms, achieving an AUC of 0.750, an accuracy of 69.1%, a sensitivity of 68.2%, a specificity of 73.8%, and an F1 score of 79%. The SHAP method identified SLQ, PIR, and education level as the primary decision factors influencing the ML model's predictions.

Conclusion: The XGBoost model effectively predicts the risk of depression in asthma patients, serving as a valuable reference for early clinical identification and intervention.

Background: Due to the absence of validated screening tools for Autism Spectrum Disorder (ASD) in adults without intellectual or language deficits in Romania, clinicians often overlook ASD during evaluations, leading to frequent misdiagnoses. To screen for symptoms of comorbid pathologies in an ASD sample compared with a non-ASD sample using the Psychiatric Diagnostic Screening Questionnaire (PDSQ) and to establish cut-off scores for the Romanian-translated versions of the Autism Quotient (AQ) and Empathy Quotient (EQ).

Methods: The study included 143 participants, 31 diagnosed with ASD and 112 from the general population. Both groups completed the PDSQ, AQ, and EQ. Analyses focused on the factorial structure, reliability, criterion validity, sensitivity, and specificity of the AQ and EQ, as well as correlations between AQ/EQ scores and PDSQ scores.

Results: Higher AQ scores were associated with anxiety, trauma, and obsessive-compulsive disorder (OCD) symptoms. A cut-off score of 21 on the AQ accurately classified 100% of clinically diagnosed ASD participants and correctly identified 80% of non-ASD participants, yielding an overall accuracy of 84%. For the EQ, a cut-off score of 26 achieved the highest specificity while maintaining optimal sensitivity, with an overall accuracy of 88%. Both AQ and EQ demonstrated good internal consistency and reliability.

Conclusion: The Romanian versions of the AQ and EQ are highly reliable screening tools for clinical use. Correlations between AQ scores and elevated anxiety, OCD, and trauma symptoms on the PDSQ highlight the importance of assessing ASD comorbidities during clinical evaluations.

Background: This Mendelian randomization (MR) study systematically examines the causal links between skin disorders and depression in individuals of East Asian descent.

Methods: MR analysis employed summary-level genome-wide association study (GWAS) data from East Asian populations. Exposures included six skin diseases: atopic dermatitis (AD) (n = 168,103), urticaria (n = 172,083), vitiligo (n = 13,327), systemic lupus erythematosus (SLE) (n = 51,009), psoriasis (n = 69,688) and acne (n = 2062). Depression was assessed using major depressive disorder (MDD) data from the Psychiatric Genomics Consortium (n = 194,548). The primary analytical methods were the inverse variance weighting (IVW) and Wald Ratio. Sensitivity analyses were conducted to detect heterogeneity and pleiotropy, incorporating Steiger tests to mitigate reverse causation.

Results: In East Asian ancestries, a significant causal relationship was identified between urticaria and an increased risk of MDD (odds ratio [OR] = 1.220, 95% CI 1.022-1.457, p = 0.028). No significant causal link was found between psoriasis and MDD. Both findings are in stark contrast to those from previous MR studies of European ancestries. No significant causal associations were observed between AD, vitiligo, SLE, acne and MDD, consistent with previous MR studies in European populations. Sensitivity analyses revealed no significant evidence of heterogeneity or pleiotropy, supporting the robustness of the causal evidence.

Conclusions: This study identifies a significant positive causal relationship between urticaria and MDD risk and no significant association between psoriasis and MDD in East Asian populations, contrasting with previous European findings. Results for other skin diseases align with previous studies. These findings highlight the need for ancestry-specific research to inform personalized prevention and intervention strategies.

Background: Obesity is a critical global health issue with increasing prevalence. Although bariatric surgery is effective, relapses are common. Pre-bariatric functioning may significantly influence these relapses.

Objective: To evaluate psychosocial functioning in individuals undergoing bariatric surgery, examining depressive symptoms, self-esteem, body satisfaction, disordered eating symptoms, and sociodemographic factors. This cross-sectional study identifies predictors of psychosocial functioning to guide interventions for sustained postoperative well-being.

Methods: The study included 175 individuals (81.7% female) attending routine preoperative evaluations at Kocaeli University Faculty of Medicine. Most participants (94.3%) were morbidly obese (body mass index (BMI) ≥40). Psychosocial functioning was assessed using the Obesity-Related Problems Scale (OP-S), with 51.4% scoring in the severe range (≥60). Depressive symptoms (Beck Depression Inventory (BDI)), Rosenberg Self-Esteem Scale (RSES), body satisfaction Scale (BSS), and Eating Disorder Examination Questionnaire (EDE-Q) were also evaluated. Correlation and regression analyses identified predictors of psychosocial functioning.

Results: The mean OP-S score was 55.81 ± 24.77. OP-S scores were significantly correlated with depressive symptoms (r = 0.462, p = 0.001), disordered eating symptoms (r = 0.410, p = 0.002), self-esteem (r = -0.322, p = 0.004), and body satisfaction (r = -0.240, p = 0.018). Regression analysis identified depressive symptoms (β = 0.24, p = 0.02) and disordered eating symptoms (β = 0.20, p = 0.03) as significant predictors.

Conclusion: Depressive symptoms and disordered eating symptoms are predictors of psychosocial functioning among individuals undergoing bariatric surgery. Addressing these factors through psychiatric evaluations can enhance psychosocial functioning, reduce relapse risk, and improve quality of life. Multidisciplinary care is essential in bariatric treatment.

Background: Childhood maltreatment (CM) is a major suicide risk factor, while social support acts as a key protective factor. However, the intricate interactions between subtypes of CM, social support, and suicidal ideation remain underexplored.

Methods: The study included 229 individuals with depression, 102 with bipolar disorder, and 216 with schizophrenia. CM was assessed using the Childhood Trauma Questionnaire-Short Form, suicidal ideation was measured with the Self-Rating Idea of Suicide Scale, and social support was evaluated using the Social Support Rating Scale. Network analysis was conducted for each disorder group to examine symptom relationships and identify central and bridge symptoms. Cross comparisons of network structures were also performed to compare the networks across the three disorders.

Results: Preliminary partial correlation analyses revealed that lower subjective support was associated with more severe emotional maltreatment in depression and bipolar disorder, as well as increased suicidal ideation in schizophrenia. Further analysis identified distinct central and bridge symptoms for each disorder. In depression, desperation was the central and bridge symptom; in bipolar disorder, emotional abuse was the most prominent central and bridge symptom, with sexual abuse also acting as a bridge symptom; and in schizophrenia, emotional maltreatment exhibited the highest centrality and bridge centrality. The general network invariance test revealed significant differences in network structures, including edge weights, and central and bridge symptoms, across the three disorders.

Conclusions: The findings highlight the complex relationships between CM, suicidal ideation, and social support across three major psychiatric disorders, offering insights into key symptoms for clinical intervention.

Background: Bipolar disorder (BD) has been studied extensively. However, no studies have investigated gender differences in the prevalence of metabolic syndrome (MetS) in initial-treatment and drug-naïve (ITDN) patients with BD. Therefore, the aim of this study was to investigate gender differences and correlates of MetS in ITDN patients with BD.

Methods: A cross-sectional study of 671 ITDN patients with BD was conducted. Demographic and clinical data were collected. Patients underwent routine serum tests including fasting blood glucose, lipid profile, thyroid function and prolactin tests. Manic, depressive and psychotic symptoms and severity of illness were measured using the Youth Mania Rating Scale (YMRS), the Hamilton Depression Scale (HAMD), the Positive Symptom Scale of the Positive and Negative Symptom Scale (PSS, items P1-P7) and the Clinical Global Impression Scale-Severity of Illness (CGI-SI), respectively.

Results: There was no gender difference in the prevalence of MetS in ITDN patients with BD. Two-way analysis of covariance (ANCOVA) revealed an interaction effect between MetS status and gender for total thyroxine (TT₄) levels (p = 0.005). In addition, multivariable logistic regression analysis revealed that TT₄ level (odds ratio, OR = 1.426, 95% CI = 1.120-1.817, p = 0.004) and PSS score (OR = 1.401, 95% CI = 1.270-1.545, p < 0.001) were significantly associated with the MetS in male BD patients; moreover, the low-density lipoprotein cholesterol (LDL-C) level (OR = 2.008, 95% CI = 1.274-3.165, p = 0.003) and PSS score (OR = 1.447, 95% CI = 1.316-1.591, p < 0.001) were significantly associated with the MetS in female BD patients.

Conclusion: TT₄ levels and psychotic symptoms were significantly associated with male BD patients with MetS. Furthermore, LDL-C levels and psychotic symptoms were significantly associated with female BD patients with MetS. Particular attention should be given to the early metabolic detection and intervention in male BD patients with high TT₄ levels and in female BD with high LDL-C levels.

Background: The purpose of this study was to investigate the incidence of comorbid type 2 diabetes mellitus (T2DM) and its associated risk factors in adult patients with severe mental disorders (SMD) who were admitted to the Affiliated Brain Hospital of Guangzhou Medical University.

Methods: We conducted a retrospective analysis of the clinical data of adult patients with SMD admitted to our hospital. The research comprised 5964 adult inpatients with SMD. Data were collected from 1 January 2023, to 31 December 2023. The collected data encompassed demographic details, classifications of mental disorders, hospitalization records, concomitant conditions, and pertinent laboratory findings. We performed descriptive and inferential statistical analyses to assess the prevalence of T2DM and identify associated risk factors.

Results: Patients with SMD had a 10.14% frequency of concurrent T2DM. In this patient cohort, our study found that age, body mass index (BMI), hypertension, triglyceride levels and apolipoprotein B levels were important risk factors for T2DM.

Conclusion: The results show that T2DM is much more common in people with SMD and suggest that several clinical and demographic traits may increase the chance of developing this condition. Extensive screening and targeted treatments are necessary for this vulnerable group.

Virtual reality (VR) is emerging as a revolutionary tool in mental health, offering new approaches to treating psychiatric disorders. Its ability to create immersive environments allows patients to safely address psychological challenges. This article reviews current applications of VR in mental health, its limitations, and future directions for research. VR has been applied to the treatment of phobias, anxiety disorders, post-traumatic stress disorder (PTSD), and eating disorders. Virtual reality exposure therapy (VRET) facilitates desensitization by allowing gradual exposures to feared stimuli, demonstrating efficacy in reducing symptoms of anxiety and social phobias. In relation to PTSD, VR helps patients to process traumatic memories in a controlled environment, proving to be a promising alternative for those who do not respond to traditional treatments. While VR offers significant benefits, such as personalization of interventions and real-time data collection, it faces methodological and accessibility challenges. The lack of rigorous research and the need for specialized equipment limit its implementation. Future research should focus on large-scale studies and the integration of VR with technologies such as artificial intelligence and biofeedback, which can improve the personalization of treatment. In conclusion, VR has transformative potential in psychiatry but, to be fully effective, it is essential to overcome existing challenges and increase its accessibility, promoting responsible and ethical use.

Background: Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children. Treatment strategies include psychotherapy, medication, education, and individual support. Recently, transcranial direct current stimulation (tDCS) has emerged as a potential therapeutic option. We undertook this meta-analysis and systematic review to evaluate the efficacy and safety of tDCS for ADHD.

Methods: The PubMed, Embase, Cochrane Library, and Web of Science databases were systematically searched for randomized controlled trials (RCTs) assessing the efficacy of tDCS for ADHD. The search terms included "transcranial direct current stimulation" and "attention deficit hyperactivity disorder". The search was conducted with no language restrictions, up to the deadline of December 1, 2024. Impulsivity symptoms, inattention, adverse events, and correct responses were analyzed using Stata 15.0.

Results: Seven studies with 290 patients were included. The results of this meta-analysis indicated that tDCS reduced impulsive symptoms [standardized mean difference (SMD) = -0.60, 95% CI (-1.04, -0.16)] as well as inattentive symptoms [SMD = -1.00, 95% CI (-1.95, -0.04)] in patients with ADHD, and did not increase adverse effects [odds ratio (OR) = 1.26, 95% CI (0.67, 2.38)].

Conclusions: tDCS can improve impulsive symptoms and inattentive symptoms in ADHD patients without increasing adverse effects, which is critical in clinical practice, especially when considering non-invasive brain stimulation. The study provided quantitative evidence that tDCS can be used for treating ADHD symptoms without adverse events.

The prospero registration: This study was registered in PROSPERO (CRD42023451277), https://www.crd.york.ac.uk/PROSPERO/view/CRD42023451277.

Background: No research has yet examined the potential association between criminal activity, schizophrenia, and the second-to-fourth digit ratio (2D:4D). Therefore, the present study aimed to evaluate if the 2D:4D differs between patients with schizophrenia with and without criminal activities.

Methods: There were 143 male participants in the study: 50 healthy controls and 93 patients with schizophrenia (51 with and 42 without a criminal history). The participants completed the Barratt Impulsiveness Scale (BIS), the Buss-Perry Aggression Questionnaire (BPAQ), and sociodemographic forms. A digital caliper was used to measure finger lengths in order to compute 2D:4D ratios. The Positive and Negative Syndrome Scale (PANSS) was used to measure the severity of schizophrenia.

Results: BPAQ, BIS, and PANSS scores were considerably higher in schizophrenia patients with a criminal background than in those without. Schizophrenia patients with a criminal background had considerably lower right and left 2D:4D ratios than controls. Schizophrenia patients with a criminal background had a significantly lower left 2D:4D ratio than those without. In people with schizophrenia, lower 2D:4D ratios in both hands-particularly the left-are linked to criminal behavior.

Conclusion: The left 2D:4D ratio in a schizophrenia patients with criminal history was a significantly lower compared with those without. Therefore, in individuals with schizophrenia, the left 2D:4D ratio may serve as an early predictor of criminal behavior. This non-invasive anatomical measurement may have the potential to help forensic investigators identify those who are more likely to commit crimes, hence improving public safety.