Actas espanolas de psiquiatria最新文献

Background: Maternal depression and anxiety during pregnancy are significant public health concerns commonly reported worldwide among pregnant women. This study aimed to investigate the impact of anxiety and depression on thyroid function, pregnancy outcomes, and sleep quality among pregnant women with hypothyroidism in the later stages of pregnancy.

Methods: Eighty cases of pregnant women with hypothyroidism in late pregnancy who were treated at Zhangjiakou First Hospital from January 2021 to October 2023 were selected for this retrospective study. The pregnant women in late pregnancy were divided into four groups according to the scores on the Hospital Anxiety and Depression Scale (HADS): control group with 20 cases, anxiety group with 18 cases, depression group with 22 cases, and anxiety-depression group with 20 cases. A comparison was made among the four groups regarding general information of pregnant women in late pregnancy, HADS scale scores, levels of free thyroxine (FT4, FT3), thyroid-stimulating hormone (TSH), occurrence of adverse pregnancy outcomes, and sleep quality at different time periods.

Results: There was no statistically significant difference in comparing general information among the four groups of pregnant women in late pregnancy (p > 0.05). There were statistically significant differences in HADS depression and HADS anxiety scores (p < 0.05), levels of FT4, FT3, TSH in pregnant women in late pregnancy postpartum (p < 0.05), occurrence of adverse pregnancy outcomes (p < 0.05), and comparison of sleep quality of pregnant women in late pregnancy at 1, 3, and 5 months of follow-up among the groups (F = 5.735, 23.930, 11.573, p < 0.05).

Conclusion: Anxiety and depression significantly impact thyroid function, pregnancy outcomes, and sleep quality in pregnant women with hypothyroidism in late pregnancy, which is detrimental to the health of pregnant women in late pregnancy. Therefore, necessary interventions are needed.

Background: Depressive symptoms may increase with age, potentially influenced by sociodemographic characteristics, stressors and support, health status, and health behaviour. It is unclear if this is the case among older adults in the Philippines. Therefore, the aim of this study is to estimate the prevalence and associated factors of depressive symptoms among older adults in the Philippines.

Methods: In all, 5209 items of cross-sectional nationally representative data from older adults (≥60 years) participating in the 2018 Longitudinal Study on Ageing and Health in the Philippines (LSAHP) were analysed. Depressive symptoms were assessed using the 11-item 3-response category Center for Epidemiological Studies Depression (CES-D) Scale.

Results: The overall prevalence of depressive symptoms was 32.1%, with 25.6% among older men and 36.5% among older women. In the final adjusted models, overall, widowed (Adjusted Odds Ratio (AOR): 1.52, 95% Confidence Interval (CI): 1.00 to 2.30), hunger (AOR: 2.22, 95% CI: 1.40 to 3.51), living alone (AOR: 1.61, 95% CI: 1.00 to 2.59), not satisfied with present life (AOR: 2.04, 95% CI: 1.09 to 3.81), body pain (AOR: 2.39, 95% CI: 1.73 to 3.31), and insomnia (AOR: 1.69, 95% CI: 1.24 to 2.31) were positively associated, while working (AOR: 0.55, 95% CI: 0.37 to 0.80) was negatively associated with depressive symptoms. In addition, among men, older age (80 years and above) (AOR: 1.95, 95% CI: 1.06 to 3.58), unmet healthcare needs (AOR: 2.19, 95% CI: 1.07 to 4.47), and hearing difficulty (AOR: 2.41, 95% CI: 1.06 to 5.52) were positively associated poor childhood health (AOR: 0.12, 95% CI: 0.04 to 0.36), while social network (AOR: 0.94, 95% CI: 0.90 to 0.99) was negatively associated. Among women, loss of bladder control (AOR: 1.69, 95% CI: 1.03 to 2.77) was positively associated with depressive symptoms.

Conclusion: One in three older adults participating in this study exhibited depressive symptoms. Sociodemographic factors, stressors, and health status factors were positively associated, and support factors were negatively associated with depressive symptoms.

Perinatal depression is a prevalent mental disorder among pregnant women, characterized by sleep disturbances, appetite changes, negative emotions, cognitive impairment, and suicidal or homicidal tendencies. These symptoms severely compromise personal well-being, disrupt family life, and burden society. Early detection and intervention are thus crucial. The tryptophan-kynurenine (TRP-KYN) pathway is central to the inflammatory hypothesis of depression and has gained significant attention in perinatal depression research. This pathway encompasses numerous metabolic enzymes and neuroactive metabolites that interact with other physiological systems, influencing neurotransmitter synthesis and neuronal development. Through these interactions, the TRP-KYN pathway exerts psychotropic effects. This article reviews the key metabolites and enzymes of the TRP-KYN pathway and examines its intersection with immune inflammation, hormones, and gut microbiota.

No abstract present.

Background: Parkinson's disease (PD) is a neurodegenerative disorder characterized by both motor and non-motor symptoms, including depression, which significantly impacts the quality of life of affected individuals. This study aims to investigate the real-world effectiveness and safety of duloxetine in treating comorbid depression in patients with Parkinson's disease and to compare its outcomes with traditional treatment approaches.

Methods: This study included adult patients diagnosed with Parkinson's disease combined with depression from December 2020 to December 2023. Based on the use of duloxetine, the cohort was divided into a traditional treatment group and a duloxetine group (traditional treatment combined with duloxetine). Patients with incomplete medical records, concurrent antidepressant therapy, or major psychiatric or neurological disorders were excluded. Retrospective data, including demographic information, treatment adherence, and various assessment scores, were collected from medical records by trained research staff.

Results: In total, 106 patients were analyzed, with 50 patients receiving traditional treatment and 56 patients receiving duloxetine. The duloxetine group exhibited significantly lower scores than the traditional treatment group in the Unified PD Rating Scale (p = 0.015), Hamilton Depression Rating Scale (p = 0.013), Beck Depression Inventory (p = 0.031), Parkinson's disease Questionnaire-39 (p = 0.006), and Clinical Global Impression-Improvement (p < 0.001) scores. In motor function assessment, the duloxetine group demonstrated improvements in kinetic tremor scores (p = 0.017), gait speed (p < 0.001), Timed Up and Go Test performance (p < 0.001), dyskinesia severity (p = 0.017), and rigidity (p = 0.019) compared to the traditional treatment group. Additionally, the duloxetine group exhibited better cognitive function across various assessments, including the Symbol Digit Modalities Test (p = 0.024), Stroop Color-Word Test (p = 0.048), and Montreal Cognitive Assessment (p = 0.024).

Conclusion: Duloxetine is associated with superior efficacy in improving motor and non-motor symptoms, overall clinical status, and cognitive function. These findings support the potential utility of duloxetine as a comprehensive treatment option for comorbid depression in Parkinson's disease.

Background: The pathogenesis of Alzheimer's disease (AD) is complex. Recent research suggests that AD patients have early disorders in brain cholesterol metabolism. Cholesterol and its derivatives accumulate in neurons, leading to p-Tau overproduction and synaptic dysfunction, initiating AD progression. Calycosin-7-O-β-D-glucoside (CG), a distinctive constituent of Astragali Radix, holds a representative position. Many clinical trials have demonstrated that CG can attenuate cerebral ischemia/reperfusion injury and preserve the structural integrity of the blood-brain barrier. However, whether CG alleviates tau-mediated neurodegeneration by increasing cholesterol efflux after lipid accumulation remains unexplored.

Methods: Ultra-performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS/MS) and multivariate data analysis were employed to investigate metabolic changes in HT22 cells induced by sodium palmitate following 24 hours of CG treatment. The potential therapeutic mechanisms of CG on AD were further examined through Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis.

Results: Metabolomic analysis characterized 24 potential biomarkers, revealing that CG could ameliorate cholesterol metabolic pathways. The results of cell experiments revealed that CG can increase the expression of enzyme cholesterol 24-hydroxylase (CYP46A1) (p < 0.05) and the level of 24 hydroxycholesterol (24-OHC) (p < 0.05), reduce the expression of p-Tau (Thr231)/Tau (p < 0.01), inhibit the formation of lipid droplets.

Conclusion: CG may inhibit the accumulation of cholesterol and its derivatives in neurons by affecting the CYP46A1-CE-Tau axis, offering a potential therapeutic strategy for AD.

Background: The Internet Addiction Test (IAT) was the first instrument created specifically to assess Internet addiction (IA). Although it was not validated during its creation, its validity has since been confirmed thanks to subsequent studies. The IAT is the first global psychometric measure tested worldwide that has been used in several studies as a research tool. Regarding the dimensions of the IAT, they were not reported by the creator of the test, during the performed factor analysis. Nonetheless, different studies have defined the test as being one-dimensional and others as having three, four, five, and six dimensions.

Methods: In the present study, seven dimensions were identified; however, there is still a lack of consensus about the number of dimensions that accurately define this test.

Results: Hence, Young's Internet Addiction Test presents a shortcoming that may be explained by the influence of several factors such as how it was applied, the place where it was applied, and the population to which it was applied. All of these are factors that could be linked to the sociocultural aspects of the adaptations that have been made to the test.

Conclusions: Moreover, the first dimension of the IAT found, the loss of self-control, is extremely important because it explains 34% of the variance of the data. However, 74% of the variance is explained by applying the 7 dimensions identified in this research. Also, the reliability analysis showed that the IAT is 89% reliable, which indicates that the elements comprising the test used in this research are suitable for measuring the construct of Internet addiction.

Background: Functional/dissociative seizures (FDS), also known as psychogenic non-epileptic seizures (PNES), are sudden, transient, and involuntary events that include motor, sensory, cognitive or autonomic function alterations. In this work we analyzed the psychopathological characteristics of a subgroup of women who suffer from FDS with the aim to analyze the role of psychological trauma, with special emphasis on trauma due to sexual abuse (SA).

Methods: Forty-five women diagnosed with FDS were included in the study (age range 18 to 64 years, mean = 34.7, standard deviation (SD) = 13.1). Clinical and psychopathological characteristics were reviewed. All patients have completed the clinical interviews, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID II) and the Global Assessment of Functioning (GAF) according to a special protocol for mental health assessment. Also, the history of sexual abuse trauma, the history of other non-sexual traumas and absence of history of trauma were reviewed.

Results: Eighty percent of the cases reported a history of trauma, and 40% reported a history of SA. Patients with a history of SA presented a significantly lower average age of seizure onset than patients with a history of other non-sexual traumas (p = 0.021). Significant associations were found between SA and post-traumatic stress disorder (PTSD) (p = 0.031), and SA and history of suicide attempts (p = 0.037).

Conclusions: SA carries serious implications for the mental health of women suffering from FDS. Mental health professionals must consider the history of this type of trauma to provide the necessary care for this patient population.

Background: Triphasic waves (TWs) on electroencephalograms (EEGs) have predominantly been observed in adults, often associated with Creutzfeldt‒Jakob disease and metabolic encephalopathy. However, TWs have also been linked to various nonmetabolic and structural abnormalities. Additionally, reports of TWs in children are rare.

Case presentation: We present the case of an 8-year and 5-month-old boy with basal ganglia lesion who exhibited TWs in the local C3 lead on electroencephalography. Subsequent EEGs revealed no additional abnormalities. During the follow-up at 1 year and 8 months, there was no significant change in the patient's condition.

Conclusion: Triphasic waves can occur in children with basal ganglia lesions, but their underlying causes may differ from those previously reported. Further research is needed to elucidate the mechanisms and clinical significance of TWs in pediatric patients.

Background: The dorsomedial prefrontal cortex (dmPFC) is considered a crucial node in emotional and cognitive processes. Voxel-mirrored homotopic connectivity (VMHC) is a validated methodology for investigating interhemispheric coordination. This study aims to elucidate the effects of electroconvulsive therapy (ECT) on the interhemispheric connectivity of the dmPFC in patients with depression, using VMHC as a measure of bilateral neural coordination.

Methods: Thirty-three patients with depression, screened at the University of Science and Technology of China (USTC), and thirty-five patients with depression, screened at Anhui Medical University (AHMU), were selected as the subjects of this study. VMHC was employed to investigate the effects of ECT on bilateral hemispheric functional connectivity. The Hamilton Depression Rating Scale (HAMD) was used to assess depressive symptoms, and the relationships between changes in HAMD scores and VMHC values were examined.

Results: Following ECT, the depressive symptoms of all participants decreased (p < 0.001). The VMHC values in the dmPFC were significantly increased in both groups after ECT (p < 0.01). No significant correlation was found between the increasing VMHC values in the dmPFC and the changes in HAMD scores in depressed patients (p > 0.05).

Conclusion: These results show that ECT regulates interhemispheric functional connectivity in depressed patients, and significantly increases the VMHC values in the dmPFC. Our findings may provide a useful method for optimizing the treatment of depression.