Alpha psychiatry最新文献

Background/objective: Whether changes in Somatic Symptom Scale-8 (SSS-8) scores adequately reflect subjective improvement in patients with somatic symptoms and related disorders (SSRD) at follow-up is unclear. The minimal clinically important difference (MCID) is a criterion of estimating clinically significant improvement derived from patients' responses to anchor questions that accurately reflect changes in their condition. This study aimed to clarify the MCID value of the SSS-8 for SSRD.

Methods: Patients with SSRD aged 18 to 84 years who attended a university hospital outpatient department in Japan were eligible. The participants were assessed using the SSS-8 for physical symptoms. After approximately 6 months of outpatient treatment, the participants were reassessed using the SSS-8 for physical symptoms. The primary endpoint was the Patient Global Impression of Change score. The secondary endpoint was the physical function items of the Multidimensional Patient Impression of Change questionnaire. These questionnaires were used to define improvements in subjective symptoms as the anchor to estimate the MCID. Receiver operating characteristic analysis was performed based on the anchor questions and the MCID values of the SSS-8 were calculated.

Results: Ninety participants were included. The primary endpoint MCID value for the SSS-8 was -6 points, with an area under the curve (AUC) of 0.87, 65.9% sensitivity, and 93.5% specificity. The secondary endpoint MCID value for the SSS-8 was -6 points, with an AUC of 0.85, 76.5% sensitivity, and 89.3% specificity.

Conclusion: The SSS-8 is a useful indicator for SSRD clinical outcomes. Patients with SSRD may need an SSS-8 score decrease of 6 or more points to notice symptom improvements.

Background: The progressive legalization and widespread use of cannabis has led to its use as a treatment for certain neuropsychiatric disorders. Traditional epidemiological studies suggest that cannabis use has an effect on some neurocognitive aspects. However, it is unclear whether cannabis use is causally related to common neuropsychiatric disorders. The present study was conducted to illustrate the causal relationships of genetically predicted cannabis use with common neuropsychiatric disorders.

Methods: We used a two-sample Mendelian randomization method using genome-wide association study (GWAS) summary statistics obtained from publicly available databases on lifetime cannabis use and 10 neuropsychiatric disorders, including multiple sclerosis (MS), Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS), autism spectrum disorder (ASD), epilepsy, generalized epilepsy, focal epilepsy, migraine, migraine with aura, migraine without aura, schizophrenia (SCZ), anorexia nervosa (AN), attention-deficit/hyperactivity disorder (ADHD), and Parkinson's disease (PD) were studied with a two-sample Mendelian randomization method for GWAS summary statistics. The inverse variance weighted (IVW) method was used as the main analysis model.

Results: Our study suggests that lifetime cannabis use is associated with an increased risk of developing PD (odds ratio (OR) = 1.782; 95% CI 1.032-3.075; p = 0.038) and an increased risk of ADHD in female participants (OR = 1.650; 95% CI 1.051-2.590; p = 0.029).

Conclusions: Cannabis intake may cause adverse effects relating to certain neuropsychiatric disorders. Therefore, special attention should be paid to the side effects of addictive drugs during clinical treatment to avoid harmful effects on the brain and neurocognition.

Objective: To tailor culturally sensitive interventional strategies for safeguarding adolescents' mental health, this study investigated the role of perceived parental involvement in predicting depressive symptoms among Chinese adolescents, considering family socioeconomic status (SES).

Methods: A cluster convenience sampling method recruited 21,818 participants from 48 middle schools across 29 provinces in China. The perceived parental involvement (PPI) Scale and the Chinese version of the center for epidemiologic studies depression scale (CES-D) assessed parental involvement and depressive symptoms, respectively. Data analysis employed linear mixed-effect models (LMM) and latent profile analysis (LPA).

Results: The results indicated that 35.26% of adolescents exhibited subclinical depressive symptoms. LMM analysis revealed that higher perceived parental involvement scores, particularly emotional involvement, significantly predicted lower CES-D scores (β = -0.45, p < 0.001). LPA identified three distinct family factors profiles, with the "High SES-High PPI" group showing the lowest depression scores.

Conclusion: The findings underscore the protective benefits of perceived parental involvement, especially emotional support, in mitigating depressive symptoms among adolescents. Specifically, adolescents from families with both high SES and high parental involvement exhibited the lowest levels of depressive symptoms, suggesting that interventions should focus on enhancing emotional support and addressing socioeconomic disparities to effectively reduce adolescent depression.

Objective: Information about the level of general personality functioning could provide benefits for tailoring substance use disorder (SUD) treatment. This study examined self-reported personality functioning among patients with SUD compared to the general population, gender specifics, and the psychometric properties of the Czech Level of Personality Functioning Scale-Self Report (LPFS-SR).

Methods: Two samples were used in this study. Sample 1 (n = 368) consisted of patients with SUD, while Sample 2 (n = 497) comprised volunteers from the general population. All participants, with an age range of 18-75 years, completed a battery of self-assessment tools, including a demographic form, the Personality Inventory for DSM-5 (PID-5), and the LPFS-SR, administered via a pencil-and-paper method. Internal consistency and several aspects of the validity of the Czech LPFS-SR were examined.

Results: The LPFS-SR showed high internal consistency as estimated by Cronbach's alpha (α ≥ 0.66) and the high mutual correlation with the PID-5 varied from 0.21 to 0.77. Principal component analysis (PCA) of the four LPFS-SR subscales indicated a single-component structure, accounting for 78.21% of the variance in Sample 1 and 79.20% in Sample 2, supporting previous results regarding the LPFS-SR factorial structure. Furthermore, gender-specific cut-off scores were obtained and are discussed in relation to previous research.

Conclusion: The findings indicate that the Czech LPFS-SR is a valid and reliable tool with acceptable discriminating capacity. It can be used in research and clinical assessments of personality functioning in patients with SUD, particularly when considering gender-specific characteristics.

Background: Schizophrenia (SCZ) is a common, chronic, severe mental disorder that is often accompanied by dyslipidemia and linked to decreased life expectancy. The prevalence of dyslipidemia among initial-treatment and drug-naïve (ITDN) patients with SCZ and the correlates influencing its occurrence and severity were determined in this study.

Methods: Demographic and clinical data including blood pressure, blood cell count, renal function, lipid profile, fasting glucose level, and thyroid function were collected from the 668 patients with ITDN SCZ included in this study. Psychopathology and illness severity were evaluated using the Positive and Negative Symptom Scale and the Clinical Global Impression Scale - Severity of Illness, respectively.

Results: The prevalence of dyslipidemia was 33.53% (224/668) and the influencing factors included higher education attainment (B = 0.43, p = 0.018, odds ratio [OR] = 1.54) and elevated systolic blood pressure (SBP) (B = 0.04, p < 0.001, OR = 1.04), which were predictive factors. Conversely, having a spouse (B = -0.40, p = 0.026, OR = 0.67), higher red blood cell counts (B = -0.77, p < 0.001, OR = 0.47), and higher free tetraiodothyronine (FT₄) levels (B = -0.06, p = 0.022, OR = 0.94) were protective factors. Specifically, elevated SBP (B = 0.01, t = 2.71, p = 0.007, 95% confidence interval [CI] = 0.00-0.01) predicted dyslipidemia severity, whereas higher FT₄ levels (B = -0.02, t = -2.45, p = 0.015, 95% CI = -0.04-0.00) had a protective effect.

Conclusions: Our study provides valuable insights into the clinical characteristics of dyslipidemia in ITDN SCZ patients. The identified factors influencing dyslipidemia occurrence and severity could serve as potential bioindicators for its prevention and intervention in clinical settings.

Objective: Physical aggression in schizophrenia patients carries significant societal implications. Previous studies on aggression prediction have primarily focused on hospitalized patients, overlooking specific rural community contexts in China. This study investigated multidimensional predictive factors to develop and validate a predictive model for predicting physical aggression in schizophrenia patients in rural communities in southwestern China.

Methods: We used convenience sampling to select 889 confirmed patients with schizophrenia from 22 rural townships recorded by the Pengzhou Mental Health Center from September to November, 2019 for baseline survey. Sixty-two candidate factors were investigated using the Morningness-Eveningness Questionnaire, Multidimensional Fatigue Inventory, and Medication Coherence Rating Scale, and aggression was evaluated using the Modified Overt Aggression Scale during a 3-month follow-up. Logistic regression was used to construct a risk prediction model and the model was validated using the receiver operating characteristic (ROC) curve.

Results: Two variable selection methods, least absolute shrinkage and selection operator and multivariate logistic regression, yielded two models: Model 1 with 27 variables and Model 2 with six variables. Both models demonstrated perfect discrimination, good calibration, and clinical utility. Model 2, with three historical and three modifiable factors, demonstrated greater utility for communities, which included physical aggression against others prior to the first episode of schizophrenia, the Modified Overt Aggression Scale score at first episode onset, mental fatigue, body mass index, experiences of discrimination, and aggression against objects before the first episode. Most predictors were non-specific to schizophrenia.

Conclusion: These findings may help to alleviate the social discrimination and constraints faced by individuals with schizophrenia in rural communities, facilitating the provision of proactive mental health services. Furthermore, our results highlight body mass index, discrimination experiences, and mental fatigue as critical areas for rural community mental health nursing professionals.

Clinical trial registration: No: ChiCTR1800015219. https://www.chictr.org.cn/showproj.html?proj=25941.

Objective: To analyze the correlation between interleukin-5 (IL-5), eosinophils (EOS), and immunoglobulin A (IgA) levels with schizophrenia, and assess their potential as auxiliary diagnostic markers for schizophrenia.

Methods: This study comprised 57 patients with first-episode schizophrenia and 340 patients with recurrent or chronic schizophrenia who were hospitalized at Beijing Huilongguan Hospital from March 2023 to August 2024, and 72 healthy volunteers were recruited as the control group. Fasting venous blood samples were collected from all participants on the second day after admission. For patients with first-episode schizophrenia, a second blood draw was performed after two months of treatment. Simultaneously, the Positive and Negative Symptom Scale (PANSS) was administered to assess the subjects. IL-5 and EOS levels were measured using flow cytometry; IgA levels were measured using immunoturbidimetry. SPSS v.29.0 was used to conduct t-tests, one-way ANOVA, correlation analysis and receiver operating characteristic (ROC) curve analysis.

Results: The first-episode schizophrenia group and the recurrent/chronic schizophrenia group had elevated IL-5 levels relative to healthy controls; however, the increase in EOS levels was specifically observed in the recurrent/chronic schizophrenia group. After treatment, the IL-5 level in the first-episode group was markedly reduced. Correlation analysis revealed that in patients with schizophrenia, IL-5 levels were positively correlated with EOS (r = 0.338, p < 0.001), and EOS levels were positively associated with disease duration (r = 0.171, p < 0.05), the ROC curve analysis revealed that IL-5 had a sensitivity of 52.9%, specificity of 69.4%, and a cut-off value of 2.445 pg/mL for predicting schizophrenia.

Conclusion: In patients with schizophrenia, the elevated levels of IL-5 and EOS appear to be disease-related rather than medication-induced, suggesting their potential involvement in the inflammatory pathogenesis of schizophrenia. Furthermore, IL-5 exhibits greater predictive accuracy for schizophrenia compared to EOS, suggesting that IL-5 may serve as a valuable biomarker for auxiliary diagnosis and stratification analysis in schizophrenia.

Objective: Hypothalamic‒pituitary‒adrenal axis response is essential for coping with acute stressors, while maladaptive stress coping may increase the risk of major depressive disorder. We previously demonstrated that behavioral patterns induced by prior psychological stress predict coping levels in response to future stressors. This study investigated whether activating corticotropin-releasing hormone (CRH) and corticosteroid receptors mediates psychological stress-induced coping behavior.

Methods: Behavioral responses in mice exhibiting a fear response elicited by exposure to 2,5-dihydro-2,4,5-trimethylthiazoline (TMT), a synthetic component of fox feces, as preceding psychological stress, were assessed by measuring central zone entries in an open-field test. Time spent immobile during the tail suspension test was evaluated as a subsequent aversive stress-coping level. CRH overexpression was induced by adeno-associated virus injection (Hypo-CRH-OE) into the paraventricular hypothalamic nucleus. Dexamethasone (10 μg/kg, s.c.), a glucocorticoid receptor agonist, or fludrocortisone (5 mg/kg, s.c.), a mineralocorticoid receptor agonist was administered 30 min before behavioral tests.

Results: Hypo-CRH-OE mice exhibited significantly higher plasma corticosterone levels than controls, without changes in baseline of locomotor activity or innate fear sensitivity. During TMT exposure, Hypo-CRH-OE mice showed lower central activity in the open-field test, accompanied by longer immobility time in the tail suspension test (TST), disrupting the correlation between these behaviors. A similar disruptive effect was observed in fludrocortisone-treated mice but not in dexamethasone-treated mice. Additionally, fludrocortisone, but not dexamethasone, prolonged immobility during the TST.

Conclusions: Preceding psychological stress-induced behavioral patterns may predict coping levels through mineralocorticoid receptor activations offering a potential target for improving stress resilience and preventing depression.

Background: The negative impact of obesity on cognitive function (CF) is well-established; nevertheless, no prior studies have explored the link between conicity index and cognitive performance. This research sought to investigate the link between conicity index and cognitive impairment.

Methods: Data were obtained from a cross-sectional analysis of the National Health and Nutrition Examination Survey 2011-2014 (NHANES), with CF evaluated by the total scores of three cognitive tests (TCT), the delayed recall test (DRT), the immediate recall test (IRT), the animal fluency test (AFT), and the digit symbol substitution test (DSST). The conicity index was derived from waist circumference, height, and weight. Multiple linear regression, smooth curve fitting, and subgroup interaction analyses were utilized to explore the correlation between conicity index and cognitive performance.

Results: The study included 2752 subjects and the results indicated that increasing conicity index was markedly associated with declining CF. In fully adjusted models, the conicity index was linked to reductions in total cognitive score (β = -16.35, 95% confidence interval (CI): -26.68 to -6.02, p = 0.0019) and DRT (β = -1.52, 95% CI: -2.74 to -0.30, p = 0.0151), IRT (β = -2.93, 95% CI: -5.37 to -0.48, p = 0.0190), AFT (β = -2.03, 95% CI: -4.88 to 0.82, p = 0.1636), and DSST (β = -9.88, 95% CI: -17.11 to -2.65, p = 0.0075) scores. However, the negative association between conicity index and AFT score was not statistically significant.

Conclusions: Lower CF is associated with a higher conicity index. The conicity index is useful for the early detection of cognitive decline.

Objective: In bipolar disorder, residual mood symptoms often persist even during the euthymic period, impairing functionality in 30-60% of patients in clinical remission. Addressing residual symptoms is critical as they are linked to reduced functionality and subjective wellbeing. This cross-sectional study aimed to determine the relationship between mindful attention awareness (MASS) and residual symptom severity in bipolar I disorder.

Methods: This study included 100 patients with bipolar I disorder (BD-I) in remission, recruited consecutively from outpatient clinics between December, 2019 and March, 2020. The patients were evaluated using the sociodemographic data form, Hamilton Depression Rating Scale (HAM-D), Young Mania Rating Scale (YMRS), and Mindful Attention Awareness Scale (MAAS).

Results: As the MAAS of the patients increases, their depressive symptoms decrease (p < 0.001). As the MAAS of the patients increases, their anxiety symptoms decrease (p < 0.001). No statistically significant relationship was found between the mindful attention awareness of the patients and their manic symptoms (p = 0.161). Two variables (HAM-D and Hamilton Anxiety Rating Scale Scores (HAM-A)) in the multiple linear regression model explain 21.8% of the change in MAAS score.

Conclusion: Residual depressive and anxiety symptoms are predictive of lower MAAS in bipolar I disorder. Incorporating strategies to manage residual mood symptoms and improve mindfulness may enhance functionality and facilitate complete remission. However, given the cross-sectional design and the lack of a control group, causal inferences cannot be made. Further longitudinal and interventional studies are needed to explore the efficacy of mindfulness-based approaches in BD-I and determine whether the observed associations are specific to this disorder.