Actas espanolas de psiquiatria最新文献

Background: High comorbidity among mental disorders challenges the utility of categorical classifications. The transdiagnostic perspective focuses on common psychological processes, potentially overcoming these limitations. The aim of this study was to explore transdiagnostic factors related to post-traumatic stress and psychopathology in a clinical sample.

Methods: Sixty-one patients (73.8% women; aged 20-66 years, M = 43.79, standard deviation (SD) = 12.75) from the Adult Mental Health Unit of the Hospital Clínico Universitario of Valencia were assessed on symptomatology (post-traumatic stress and psychopathology) and psychological variables (emotional dysregulation, resilience, personality, social support, and stressful life events).

Results: Our results indicated elevated post-traumatic stress scores (M = 70.49, SD = 20.33), suggesting clinically significant distress, together with low exposure to stressful life events (Median (Mdn) = 2.00; interquartile range (IQR) = 2.00). Post-traumatic stress and psychopathology were positively correlated with emotional dysregulation and negatively with resilience, social support, extraversion, and conscientiousness. Higher post-traumatic stress and psychopathology were linked to low social support, low extraversion, and high emotional dysregulation. Emotional dysregulation emerged as a key moderating variable, potentially diminishing the protective effects of resilience on post-traumatic stress.

Conclusions: Overall, findings support the transdiagnostic approach, highlighting that factors like emotion regulation contribute not only to symptom development but also critically influence how risk and protective factors affect mental health outcomes, emphasizing the importance of targeting these processes in clinical intervention and prevention efforts.

Background: Thought-Action Fusion (TAF) is one of the cognitive variables and thought misinterpretations that have been extensively studied in Obsessive-Compulsive Disorder (OCD). However, further research is needed on the specific factors contributing to the development of TAF in patients with OCD. Since autistic traits and TAF are related to cognitive processes, we hypothesized in this study that autistic traits as well as schizotypal traits and obsessive-compulsive symptoms may be associated with TAF severity in OCD patients.

Methods: In this cross-sectional study, eighty-three patients (aged 18 to 65) with OCD were assessed using the Yale Brown Obsessive-Compulsive Scale (Y-BOCS), Schizotypal Personality Questionnaire (SPQ), Autism Spectrum Quotient (AQ), Thought-Action Fusion Scale (TAFS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI).

Results: We found that attention switching, attention to detail, and communication dimensions of the AQ were associated with higher TAF-Likelihood/Self. There was a significant association between attention shifting and TAF-Moral, while attention to detail was significantly associated with TAF Likelihood/Others. Y-BOCS-Total (β = 0.338, p = 0.001), and cognitive-perceptual traits (β = 0.295, p = 0.018) were significantly associated with TAF-Moral. Likelihood/Self dimension of TAF was significantly associated with Y-BOCS-total (β = 0.386, p < 0.001), BDI (β = -0.333, p = 0.017), AQ-Total (β = 0.250, p < 0.001) and Cognitive-Perceptual schizotypal traits (β = 0.289, p = 0.016). The severity of TAF-Likelihood/Others was significantly associated with Y-BOCS-Total (β = 0.279, p = 0.012).

Conclusions: We suggest that in addition to the severity of OCD and cognitive-perceptual traits, higher autistic traits may also contribute to increased levels of TAF-Likelihood/Self.

Background: The relationship between the gut microbiome and Autism Spectrum Disorder (ASD) has been the subject of growing interest in scientific research. Research into the relationship between the gut microbiome and ASD has gained relevance in recent years as recent studies have identified significant differences in the gut microbiome abundance and composition in ASD children compared to neurotypical ones. However, little is known about the microbiome interplay, changes and relationship in parents and children with ASD, considering that they share a consistent environment. Charactering the microbiota of trio-type families with a child diagnosed with autism.

Methods: The hypervariable region of the 16s ribosomal gene was sequenced from stool samples from adolescents with ASD and their parents. The analysis was performed using various software programs, including QIIME2 and DADA2.

Results: In this paper, we discuss this relationship in three families, and observed that the gut microbiome of the offspring with ASD is more similar to the mother's than the father's microbiome.

Conclusions: These observations could lead to the understanding of the potential heritability of the disorder through parental connectedness of the gut microbiome and eventually to the development of interventions aimed at modulating the gut microbiota to improve symptoms associated with ASD.

Background: The relationship between gastric cancer and depression is an area of active investigation, and recent studies suggests a bidirectional association. Understanding this relationship is crucial for improving treatment approaches and mental well-being in patients with gastric cancer.

Methods: We analysed the correlation between gastric cancer and depression, using data from Genome-Wide Association Studies. Causal links were explored using Mendelian randomisation (MR) and Gene Expression Omnibus.

Results: Forward MR analysis identified 24 single nucleotide polymorphisms (SNPs) meeting the criteria for instrumental variables. The analysis provided evidence of a causal effect of gastric cancer on depression (odds ratio [OR]: 1.132, 95% confidence interval [CI]: 1.032-1.231). The reverse MR analysis, examining the potential causal effect in the opposite direction, identified 15 SNPs; however, no significant causal effect of depression on gastric cancer was detected (OR: 0.834, 95% CI: 0.504-1.380). Cross-pathway analysis identified 23 genes common to both conditions. Protein interaction network analysis of these shared genes revealed that lactoferrin, lipocalin-2 and matrix metalloproteinase-9 are potential key genes in the shared pathophysiology of both diseases.

Conclusions: Our study demonstrates a causal effect of gastric cancer on depression, whereas depression does not exert a causal effect on gastric cancer. These findings provide evidence for targeted depression prevention strategies for patients with gastric cancer.

Background: To investigate the relationship between postpartum depression (PPD) symptoms in primiparous women and uterine recovery, sleep quality and postpartum stress.

Methods: This retrospective study enrolled 194 postpartum women who underwent 42-day postpartum examinations in our hospital from February 2024 to February 2025. General demographic information, uterine recovery (including uterine fundal height decline, lochia volume and pelvic floor muscle recovery), sleep quality (determined using the Pittsburgh Sleep Quality Index [PSQI]) and postnatal stress levels (measured using the Maternal Postpartum Stress Scale [MPSS]) were collected through the electronic medical record system. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Mothers with an EPDS score ≥10 were classified into the PPD group, and those with <10 were classified into the non-PPD group. Univariate and multivariate logistic regression analyses were performed to assess the factors influencing PPD.

Results: A total of 194 primiparous women were included, 56 in the PPD group and 138 in the non-PPD group. The PPD group showed significantly higher percentage of high school education and below, discordant relationship with husband, lack of regular maternity check-ups, illness during pregnancy and poor health of newborn than the non-PPD group (p < 0.05). PSQI (p = 0.001) and MPSS (p < 0.001) scores were significantly higher in the PPD group than in the non-PPD group. In terms of uterine recovery, the PPD group had a significantly lower lochia volume at 24 and 48 h postpartum than the non-PPD group (p < 0.001) and poorer recovery of pelvic floor muscle strength (p < 0.05). Logistic regression analysis showed that high school education or less, illness during pregnancy, PSQI and MPSS scores were independent risk factors for PPD, whereas higher lochia volume at 24 and 48 h postpartum and pelvic floor muscle strength ≥grade III were protective factors.

Conclusions: This study identified several specific independent risk factors (lower education level, illness during pregnancy, poor sleep quality and high postpartum stress) and protective factors (adequate lochia volume and good pelvic floor muscle recovery) for PPD. Clinical practice should strengthen the identification and intervention of high-risk groups and pay attention to the integrated management of postpartum physiological recovery and mental health.

Background: Temporal lobe epilepsy (TLE) is a chronic stress condition characterized by affective and cognitive deficits. This study analyzed differences in affective and cognitive functioning between patients with TLE and another chronically stressed population - caregivers of patients with epilepsy - as well as the relationships between affective and cognitive outcomes.

Methods: In this cross-sectional study, 40 adults (20 with left TLE and 20 caregivers; mean age 48.43 ± 8.86 years) underwent a neuropsychological assessment evaluating affectivity, attention, executive function, language, and memory.

Results: Patients with TLE and caregivers did not differ in anxiety, depression, attention, executive functions, or visual memory. However, patients with TLE had poorer semantic verbal fluency (p = 0.02), naming (p < 0.0001), short-term verbal recall (p = 0.027), long-term verbal recall with semantic cues (p = 0.005), long-term verbal recognition (p = 0.017), and verbal discriminability (p = 0.001). The group (epilepsy vs. caregiver) significantly moderated the association between depression and long-term verbal recognition (B = -0.12, standard error (SE) = 0.05, p = 0.03, 95% confidence interval (CI) [-0.23, -0.01]), with higher depression scores being associated with poorer verbal recognition in patients with epilepsy (p = 0.001) but not in caregivers (p = 0.74).

Conclusions: These findings suggest a specific pattern of verbal dysfunction and increased cognitive vulnerability to depression in patients with TLE, compared to another chronically stressed group. Although the present study cannot determine the mechanisms underlying these associations, the results underscore the clinical relevance of assessing these variables together and may inform the development of tailored interventions.

Background: This study aimed to investigate the prevalence of anxiety and depression symptoms and analyse the associated risk factors in postmenopausal women with type 2 diabetes mellitus (T2DM) and comorbid hypothyroidism.

Methods: A cross-sectional study design was employed, enrolling 152 postmenopausal women with T2DM and hypothyroidism who attended Huainan Chaoyang Hospital between February 2024 and August 2025. Psychological status was assessed using the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale. Demographic characteristics, clinical features and laboratory parameters were collected.

Results: Amongst the 152 patients, the prevalence rates of depressive and anxiety symptoms were 26.97% and 34.87%, respectively. Between-group analyses showed that the depression group had significantly longer durations of T2DM and hypothyroidism and higher glycosylated haemoglobin (HbA1c) and thyroid-stimulating hormone (TSH) levels than the non-depression group. The anxiety group was significantly younger than the non-anxiety group, with longer T2DM duration and higher TSH levels (p < 0.05). Multivariate logistic regression analysis identified increased HbA1c level (Odds Ratio [OR] = 1.43), increased TSH level (OR = 1.36) and longer T2DM duration (OR = 1.21) as independent risk factors for depressive symptoms, whereas higher income served as a protective factor (OR = 0.19). For anxiety symptoms, younger age (OR = 0.88), longer T2DM duration (OR = 1.19) and increased TSH (OR = 1.23) were independent risk factors.

Conclusions: Anxiety and depressive symptoms are prevalent amongst postmenopausal women with T2DM and hypothyroidism. Poor glycaemic control, thyroid dysfunction and longer diabetes duration are primary risk factors.

Background: This review aimed to determine whether executive dysfunction is a characteristic of survivors of central nervous system tumors in children and adolescents, including Astrocytoma, Neurofibromatosis-1, Medulloblastoma, and Pilocytic Astrocytoma.

Methods: A review and meta-analysis of executive function assessed with Behavior Rating Inventory of Executive Function (BRIEF) in individuals with these tumor types.

Results: The main findings of the meta-analyses can be summarized as follows: (i) Neurofibromatosis type 1 (NF1) - BRIEF (parents): Children with NF1 show significant deficits in executive functions according to the parent-rated BRIEF, with an overall model effect size of d = 0.81 (p < 0.001). The most affected areas are working memory, monitoring, and metacognition, indicating that these deficits are consistent and clinically relevant. (ii) NF1 - BRIEF-P (parents and teachers): In this meta-analysis, the overall model effect size was d = 0.37 (p < 0.001), showing moderate but significant difficulties in executive functions. Both parents and teachers report problems in working memory and emerging metacognition, reflecting a consistent pattern across different observational contexts. (iii) Medulloblastoma vs. other tumors: Patients with medulloblastoma exhibit marked deficits in executive functions compared to other brain tumors, with an overall model effect size of d = -0.74 (p < 0.001). The most affected areas include inhibition, initiation, regulation, and metacognition, with consistent findings across the included studies.

Conclusions: Executive deficits are observed in individuals with brain tumors or survivors, significantly affecting their academic, social, and emotional lives. Early identification, along with educational and neuropsychological support, is essential to preventing these deficits from interfering with academic, personal, and professional functioning.

Background: Diagnostic stability in child and adolescent psychiatry is a key indicator of validity and essential for clinical decision-making. Few longitudinal studies have examined diagnostic trajectories after a first emergency psychiatric contact.

Methods: We conducted a retrospective observational cohort study at Santa Maria University Hospital (Lleida, Spain). A total of 583 patients aged 4-18 years presenting for their first psychiatric emergency visit between 2017 and 2023 were included, with 24-month follow-up. Sociodemographic and clinical data were extracted from Electronic Health Records. Diagnostic transitions were summarized using transition matrices. An exploratory association analysis (Apriori algorithm) identified frequent T1→T2 patterns, reported with confidence and lift. Diagnostic stability was defined as the proportion of patients retaining the same diagnosis at follow-up.

Results: Median age at baseline 14.9 years (interquartile range [13-16]); 54.55% were female. Schizophrenia/psychosis showed the highest stability (71%), followed by intellectual disability with gender identity disorder (67%). Mood disorders showed moderate stability (~44%), while others such as eating disorders (26%) or conduct disorders (17%) had lower stability. The strongest associations were "no prior diagnosis → eating disorder" (confidence = 1.00; lift = 12.76) and "autism spectrum disorder + attention-deficit/hyperactivity disorder (ADHD) → conduct disorders" (confidence = 0.66; lift = 2.55).

Conclusions: Diagnostic stability is heterogeneous, with high persistence in schizophrenia/psychosis and low in eating disorders and ADHD. Association analysis identified specific trajectories that may help anticipate clinical evolution. Findings highlight the importance of longitudinal evaluation in early psychiatric care.