Alpha psychiatry最新文献

Objective: The aim was to analyze the effects of nurse-led mindfulness-based cognitive therapy (MBCT) in hospitalized elderly suicide survivors.

Methods: The data of middle-aged and elderly suicide survivors in the medical system and nursing records of our hospital from January 2018 to August 2023 were retrospectively collected. The patients were divided into conventional group and MBCT group according to whether they actively received MBCT. The general demographic data of the patients and the changes in the scores of Suicidal Ideation Scale (SSI), Beck Hopelessness Scale (BHS), Patient Health Questionnaire 15 (PHQ-15), and Geriatric Depression Scale (GDS-15) at admission and 3 and 6 months of follow-up were collected. Propensity score matching was used to balance the baseline data of the 2 groups. Multiple logistic regression analysis was used to determine the effect of the inpatient care program on each score.

Results: A total of 160 patients were included in the study, including 100 patients in the MBCT group and 60 patients in the conventional group. There was no significant difference in baseline data between the 2 groups after matching (P > .05). Suicidal Ideation Scale score, BHS score, PHQ-15 score, and GDS-15 score in MBCT group were lower than those in conventional group at 6 months of follow-up (P < .05). At the same time, multiple logistic regression analysis showed that the intervention program was the main factor affecting the SSI (OR = 1.538, P = .010), BHS (OR = 1.614, P = .006), PHQ-15 (OR = 1.797, P = .001), and GDS-15 scores (OR = 1.642, P = .004) at 6 months of follow-up.

Conclusions: The application of nurse-led MBCT in hospitalized elderly suicide survivors may reduce suicidal ideation, hopelessness, and depression and improve physical symptoms.

Background: Numerous studies have examined the links between mental disorders such as depression and bipolar disorder, and gastrointestinal (GI) diseases. However, few studies have investigated the link between mood swings and GI diseases. Given the impact of mood swings on various conditions and the growing comprehension of the gut-brain axis, this study aims to explore their causal relationship using Mendelian randomization (MR) methods.

Methods: Single-nucleotide polymorphisms (SNPs) associated with mood swings were obtained from a recent study. SNPs associated with GI diseases were identified from the FinnGen project. We conducted two-sample bidirectional MR analyses using three methods, primarily the inverse variance weighting (IVW) method. Furthermore, we performed sensitivity analyses and false discovery rate (FDR) analysis to validate the accuracy and robustness of the results.

Results: Bidirectional MR analysis revealed significant causal effects between mood swings and GI diseases according to the IVW method (odds ratio (OR): 1.213; 95% confidence interval (CI): 1.118-1.316; P = 3.490e-6; P _FDR = 8.730e-5). Mood swings were linked to an increased risk for 11 of 24 diseases, including five upper GI diseases (gastroesophageal reflux disease (GERD), acute gastritis, gastroduodenal ulcer, duodenal ulcer, and functional dyspepsia), two lower GI diseases (diverticular disease of the intestine and irritable bowel syndrome (IBS)) and four hepatobiliary and pancreatic diseases (nonalcoholic fatty liver disease (NAFLD), chronic pancreatitis, acute pancreatitis, and pancreatic cancer). Inverse MR analysis showed no causal relationship between 24 GI diseases and mood swings.

Conclusions: This comprehensive MR analysis suggests that genetically predicted mood swings may be a risk factor in the development of GI diseases. Interventions for mood swings may help to treat GI diseases.

Objective: Treatment-resistant depression (TRD) affects around 20-30% of people with major depressive disorder. In 2019, esketamine nasal spray was approved for TRD by both the US Food and Drug Administration and the European Medicines Agency. While its clinical efficacy and safety are proven, the mechanisms underlying its antidepressant effect remain unclear. The use of metabolomics may allow understanding the metabolic effects of esketamine and predicting biological features associated with clinical response in TRD. Nonetheless, there is a lack of studies exploring the predictive value of metabolomics. The Resistant Depression Response to Esketamine Assessing Metabolomics (ReDREAM) project aims at identifying metabolic biosignatures that may represent novel correlates of response to esketamine treatment.

Study design: This is the protocol of an observational, prospective study.

Methods: We plan to select 60 people with TRD from 3 clinical sites in Italy. The participants will be administered with esketamine nasal spray, following standard clinical practice, twice a week for 4 weeks ("induction phase"), then once a week for 4 additional weeks ("maintenance phase"). We will test the correlations between baseline metabolic profile and depressive symptom improvement at study endpoints (weeks 4 and 8) and we will explore the likelihood of different metabolic phenotypes between responders and non-responders.

Expected results: An involvement of energy metabolism, amino acid metabolism, urea cycle, and nitric oxide synthesis in response to treatment with esketamine nasal spray is hypothesized.

Conclusion: Unbiased data from untargeted metabolomics associated with clinical changes after esketamine treatment may contribute to define new paradigms for precision psychiatry-oriented, personalized care of TRD.

Background: This study used functional near-infrared spectroscopy (fNIRS) to investigate brain activation patterns in children with attention deficit hyperactivity disorder (ADHD) with and without additional comorbidities to identify disease-related biomarkers by the neuroimaging that will facilitate to make a diagnosis decision.

Methods: In this study, 165 medication-naive children aged 7 to 15 years were recruited and categorized into four groups: ADHD, ADHD with learning disabilities (ADHD&LD), ADHD with oppositional defiant disorder (ADHD&ODD), and healthy controls. A multichannel fNIRS system was used to monitor hemodynamic changes at rest state in the prefrontal and temporal lobes of the brain. The amplitude of a low-frequency fluctuation (ALFF) matrix was calculated by summation and averaging of the square root of the signal power spectrum. One-way analysis of variance was used to identify statistical differences between channels.

Results: All ADHD children presented significantly higher ALFF values in different brain regions when compared with the healthy controls. Patients with ADHD&LD exhibited higher ALFF values in the medial prefrontal cortex (P _Ch38 = .01, P _Ch48 = .01), temporal cortex (P _Ch22 = .04, P _Ch41 = .002, P _Ch51 = .001), and the left ventrolateral prefrontal cortex (P _Ch39 = .0009, P _Ch50 = .001), whereas ADHD&ODD children were not significantly different to those diagnosed with ADHD.

Conclusions: ADHD with learning disabilities (LD) possessed a different pathogenesis from ADHD, manifested as lower functional brain activity in the medial prefrontal cortex, temporal cortex, and the left ventrolateral prefrontal cortex, while ADHD&ODD did not present significant changes compared with ADHD. ODD-related symptoms may be part of ADHD symptoms rather than being an independent disorder.

Objective: Diabetes mellitus (DM) is a global epidemic; comorbid depressive symptoms are highly prevalent worldwide and commonly manifests as physical symptoms, including functional dyspepsia (FD), a gastrointestinal psychosomatic disorder. This study aimed to explore the effects of comorbid depressive symptoms and DM on FD in older patients.

Methods: In total, 420 older patients with DM completed measures of depression, anxiety, and FD. Relevant demographic characteristics and medical information were self-reported and obtained from the hospital information system.

Results: Among older patients with DM, 30.48% had depressive symptoms. Patients with depressive symptoms were more likely to have FD than those without (42.19% vs. 20.21%, P = .000). Dyspepsia symptoms were more frequent in patients with depression (P = .022). The greater the amount of dyspepsia symptoms, the higher the depression symptoms score (P = .000). Furthermore, dyspepsia symptoms were positively correlated with depressive symptoms (r values were 0.292, 0.311, 0.297, 0.369; all had P < .05). Both FD subtypes, postprandial distress, and epigastric pain syndromes affected depressive symptoms (P < .05). Smoking was significantly associated with FD (P < .05). Diabetes mellitus complications, such as diabetic neuropathy, different therapeutic methods, and anxiety symptoms, influenced FD overlap (x ² values were 6.298, 16.314, and 30.744; P < .05). Anxiety (odds ratio = 1.832, 95% Confidence Intervals (CI) 1.185-2.834) was a risk factor for FD in comorbid depressive symptoms and diabetes (P < .05).

Conclusion: Comorbid depressive symptoms and DM overlapped with physical symptoms, such as FD, in older patients with DM. Lifestyle, diabetic factors, and anxiety were the associated risk factors.

Objective: Antisocial behavior and antisocial personality disorder (ASPD) cause serious harm to society and families. Ethnicity may have an impact on an individual's antisocial behavior and the incidence of ASPD. Therefore, this study aimed to investigate the current status of antisocial behavior and ASPD among youth and its correlation with ethnicity in ethnic minority areas in China.

Methods: A total of 2475 Chinese youth (1794 under 18 and 681 greater than or equal to 18) were recruited from December 1 to 30, 2021, in Yunnan, China. All participants completed a General Information Questionnaire and the Personality Diagnostic Questionnaire Fourth Edition Plus (PDQ-4+). Associations between antisocial behavior and ASPD and sociodemographic factors such as ethnicity were examined using binary logistic regression analysis.

Results: The positive rate of antisocial behavior screening in youth was 5.4% (95% CI (confidence interval): 4.3-6.4), with a positive rate of ASPD screening of 4.4% (95% CI: 2.9-6.0). Male, single-child and maternal education level at senior high school and above were risk factors for positive antisocial behavior screening, while senior high school grade and medium subjective family economic status were protective factors for positive antisocial behavior screening. Being male and paternal educational background were risk factors for positive ASPD screening.

Conclusion: This study found high rates of positive screening for antisocial behavior and ASPD in youth and no significant differences in ethnicity. These results can be used to inform personality development.

Objective: The study aimed to evaluate negative and positive emotional responses to acute psychological stress in individuals with early life stress (ELS).

Methods: One hundred sixty-one participants from the Birmingham community in Alabama completed the study and were stratified into 2 groups based on measurements of ELS using the Childhood Trauma Questionnaire and a confirmatory clinical interview. Acute psychological stress, that is, the Trier Social Stress Test (TSST), was administered, and emotional responses were measured using the Visual Analogue Scale. Comparisons utilized chi-square for categorical variables and t-test for continuous variables. Analysis of covariance (ANCOVA) was applied to compare the 2 groups after controlling for confounding variables. Stepwise multiple linear regression analysis was used to investigate predictive power of variables for emotional responses to the TSST.

Results: Participants with ELS experienced less pleasantness at the baseline (P = .02), and 1 minute (P = .04), but not 90 minutes time points compared to the non-ELS group. Participants in the ELS group also reported higher anxiety at baseline (P = .003), and 90 minutes (P = .04) post-TSST. Data analysis showed the effect of time on emotional responses during the TSST. Different emotional responses, including pleasantness, anxiety, fatigue, and vigor, were able to be predicted by ELS severity.

Conclusion: Our data demonstrates that individuals with ELS presented different positive and negative emotional responses when exposed to acute psychological stress. Our findings may be useful for clinicians who work with individuals with ELS. Our findings also highlight the importance of recognizing emotional responses and of building up resilience in response to acute stress.

Objective: This study investigated the differences in sociality, communication, and autism severity in children with autism spectrum disorder (ASD) according to the presence or absence of siblings, the number of siblings, the order of birth, and the sex of sibling.

Methods: We included 71 children with autism spectrum disorder who visited University Hospital as outpatients. We compared the communication and socialization scores using the Korean Version of the Vineland Adaptive Behavior Scale, second edition (K-VABS II); social interaction, communication, and language using the autism diagnostic interview-revised (ADI-R); and the total score of the Korean-Childhood Autism Rating Scale 2 (K-CARS 2) according to the presence or absence of siblings, the number of siblings, the order of birth and the sex of sibling. Data were evaluated with independent t-tests and analysis of variance (ANOVA) tests.

Results: The patient's average age was 48.8 ± 13.6 months. There was a significant difference in the total score of K-CARS-2 according to the sex of siblings. The male sibling group was 34.36 ± 6.11 and the female sibling group was 30.29 ± 6.41 points, respectively.

Conclusion: This result indicates that the quality of sibling interactions in families with a child with ASD may play a significant role in reducing ASD severity and improving the quality of sibling interactions, rather than the number of siblings alone affecting the social interactions of children with ASD.