Actas espanolas de psiquiatria最新文献

Background: This study aims to analyse the developmental trajectory of depression in patients undergoing concurrent chemoradiotherapy (CCRT) for cervical cancer and its influencing factors.

Methods: A retrospective analysis of clinical data was performed on 160 patients with cervical cancer who received CCRT at our hospital between July 2023 and June 2025. Individuals with depression were assigned to the depressed group, whereas those without depression were assigned to the non-depressed group. Employing latent class growth modelling to identify depression trajectories in cervical cancer patients undergoing CCRT. The factors influencing the latent classes of depression trajectories in patients were analysed through logistic regression.

Results: The depressed group had higher rates of household monthly income per capita of less than 5000 RMB (1 USD = 7.1 RMB), stage III/IV tumour stage and avoidance/submission coping methods than the non depressed group (p = 0.001, 0.030, < 0.001) and had lower Multidimensional Scale of Perceived Social Support (MSPSS) scores (p = 0.001). Three distinct depression trajectories were identified: a low-level stable group (n = 31), a moderate-level increasing group (n = 54) and a high-level decreasing group (n = 29). The logistic regression analysis results indicated that patients with a household income per capita below 5000 RMB, stage III/IV tumour stage, avoidance/submission coping style and lower MSPSS scores exhibited a higher likelihood of entering the medium-level rising group and the high-level declining group compared to the other group (p < 0.05).

Conclusions: Depression in patients with cervical cancer exhibits three distinct developmental trajectories. Household income per capita, tumour stage, coping style and MSPSS score may influence these trajectories. Thus, prompt intervention targeting these potential influencing factors is essential for managing the progression of depression.

Background: Elderly patients undergoing pulmonary lobectomy with incision are at a high risk for postoperative cognitive dysfunction (POCD). Intraoperative esketamine may offer potential neuroprotective benefits. This study aimed to evaluate the efficacy of intraoperative esketamine in reducing the incidence of POCD in elderly patients undergoing pulmonary lobectomy with incision.

Methods: In this single-blind, controlled clinical trial, patients (aged 65-75 years) undergoing conventional pulmonary lobectomy were randomly allocated to receive esketamine (0.3 mg/kg/h) or remifentanil (0.1-0.2 µg/kg/min) during surgery. Cognitive function was assessed using the mini-mental state examination (MMSE) and negative emotional scores were recorded at baseline and multiple postoperative time points. Intraoperative and postoperative parameters, including heart rate (HR) and mean arterial pressure (MAP), pain scores and adverse events, were recorded. Blood samples were collected to measure amyloid-beta (Aβ) and microtubule-associated protein tau (tau) concentrations.

Results: No significant difference was found in the incidence of postoperative delirium between the two groups, but the esketamine group exhibited a significantly lower incidence of POCD on days 1 and 3 postoperatively than the control group. The esketamine group also had significantly higher serum Aβ42/40 levels and significantly lower tau levels on day 1 postoperatively. At the end of surgery, the HR, MAP and pain visual analogue scale score of the control group were significantly higher than those of the esketamine group. No significant differences were observed in terms of adverse events between the two groups.

Conclusion: Intraoperative administration of esketamine (0.3 mg/kg/h) was associated with a lower incidence of POCD and more stable hemodynamic indicators in elderly patients undergoing thoracic surgery, without increasing adverse events. The application of esketamine indicates a possible benefit with a favourable safety profile in reducing postoperative cognitive decline in this population.

Trial registration: Chinese Clinical Trial Registry, ChiCTR2200065266.

Background: Primary immune Thrombocytopenia (ITP) is an autoimmune disease characterised by Thrombocytopenia, which can cause physical symptoms such as bleeding and impose a heavy burden on patients' mental health and quality of life (QOL). This study aims to investigate the impact of anxiety level and degree of alexithymia on the QOL of adult patients with ITP.

Methods: This investigative study included 148 patients with ITP attending our haematology department from June 2021 to June 2023. The following scales were used: the Hamilton Anxiety Scale (HAMA) to assess the patients' anxiety level, the Toronto Alexithymia Scale-20 (TAS-20) to assess the degree of alexithymia and the ITP-Patient Assessment Questionnaire (ITP-PAQ) to assess QOL. Pearson correlation and multifactor linear regression analyses were used to explore the relationship among anxiety level, degree of dysphoria and QOL.

Results: The mean HAMA score of 148 patients with ITP was 14.31 ± 3.61, of which 146 had varying degrees of anxiety. The mean TAS-20 score was 56.11 ± 8.41, and 106 cases had varying degrees of alexithymia. Pearson correlation analysis showed that HAMA scores (r = -0.316, p < 0.001) and TAS-20 scores (r = -0.254, p = 0.002) were significantly negatively correlated with ITP-PAQ scores. The results of multifactorial linear regression analysis showed that anxiety level (p < 0.001), alexithymia (p = 0.015), diabetes mellitus comorbidities (p = 0.046), stage of disease (p = 0.027) and platelet (PLT) level (p = 0.032) were independent risk factors for the QOL of patients with ITP.

Conclusion: Anxiety level and alexithymia degree significantly affect the QOL of patients with ITP and are independent risk factors for QOL. Clinical work should pay attention to the psychological state of patients with ITP and the timely identification and intervention for anxiety and alexithymia to improve QOL.

Background: Obesity and psychological symptoms often coexist during childhood and adolescence. Understanding the long-term associations between these conditions is essential for designing effective prevention and intervention strategies. The study presented here aimed to examine recent evidence concerning the longitudinal relationship between obesity and commonly comorbid psychopathologies such as depression, anxiety, and eating disorders during childhood and adolescence.

Methods: A systematic review of prospective observational studies was conducted using the PubMed, Scopus, and EBSCOhost databases, covering publications from 2010 to 2025. Twenty-one high-quality studies met the inclusion criteria, especially of participants aged six to 18 years and follow-up periods of at least two years.

Results: A narrative synthesis of 21 prospective studies reveals key longitudinal associations between obesity and psychological symptoms throughout childhood and adolescence, with gender-specific patterns becoming more evident during the teenage years. The collective evidence suggests a bidirectional relationship between eating disorders and obesity. Furthermore, there is evidence indicating a potential prospective association between elevated weight trajectories and depressive symptoms, a connection that appears to be influenced by gender. Specifically, the association from depression to obesity may be more pronounced in older children, particularly girls. Due to the limited number of studies focusing on anxiety symptoms, definitive conclusions regarding their relationship with obesity remain elusive.

Conclusions: This systematic review points to the scarcity of prospective studies that extend beyond two years of follow-up to explore the bidirectional association between obesity and psychological symptoms in youth. While the findings of the present study indicate mutual influences, particularly for eating disorders and depressive symptoms, further research involving longer follow-up periods and diverse populations is warranted. The present study's results emphasise the importance of early, integrated prevention efforts that address common risk factors.

Background: Most studies show that individuals who abuse psychoactive substances (PAS) have an increased risk of aggressive behavior and the degree of increased risk varies depending on the type of PAS. This study aimed to determine the risk and level of risk for committing violence among individuals dependent on alcohol and other PAS.

Methods: A cross-sectional study was carried out, including a sample of N = 100 respondents with alcohol dependence and other PAS dependence. The Historical-Clinical-Risk Management-20, Version 3 (HCR-20V3) was used to assess the risk of committing violence.

Results: This study found no significant difference in the overall scores of the HCR-20V3 scale between the examined groups regarding the risk of committing violence [the historical section - presence (p = 0.253) and relevance (p = 0.379); the clinical section - presence (p = 0.549) and relevance (p = 0.191); the risk management section - presence (p = 0.506) and relevance (p = 0.788)]. The results obtained for certain elements of the HCR-20V3 (violence, violent behavior, and violent ideation) showed statistical significance between the examined groups: the presence of violence risk (p = 0.042), violent ideation (p < 0.001) and violent behavior (p = 0.016) and relevance of violence risk (p = 0.009) and violent ideation (p < 0.001) was more pronounced in the alcohol dependent group.

Conclusion: Our data confirm that respondents with alcohol dependence exhibit a higher risk of committing violence compared to respondents with other PAS dependence. Findings show that conducting risk assessment for committing violence among respondents with alcohol dependence and respondents with other PAS dependence is crucial, as both the healthcare system and outpatient services should focus on maintaining established abstinence and preventing relapse in terms of potential repeated violence-related behaviors.

Background: Eating disorders are a cluster of challenging psychiatric and medical conditions that constitute a major problem in adolescents and young adults. Animal-assisted interventions are currently a promising complementary therapy with great development in the hospital field.

Methods: The study is a non-randomized clinical trial designed with two groups under assessment. The first group consisted of 15 female patients at a Day Hospital diagnosed with eating disorders who received animal-assisted therapy. The second group had a sample of 15 patients from the same hospital with similar diagnoses and matched characteristics to the intervention group. Anxiety, depression, eating symptoms, grip strength, and health-related quality of life were analyzed both previously and after the intervention.

Results: ANOVA results showed a significant between-group reduction in the state anxiety levels (p = 0.011, ηp2 = 0.211), with a significant decrease in the intervention group (p = 0.003). Interpersonal distrust (p = 0.042) and fear of maturity (p = 0.012) subscales in the Eating Disorder Inventory (EDI2) questionnaire had larger improvement when comparing pre- and post-measures in the intervention group. A similar trend was observed for the rest of the eating symptoms subscales and grip strength in the group treated with the animal-assisted intervention.

Conclusion: This study suggests that dog-assisted therapy may be an effective complementary intervention for reducing state anxiety in adolescents with eating disorders. Given the role of anxiety in the maintenance of anorexia nervosa, targeting this symptom could have therapeutic benefits. Additionally, improvements in interpersonal distrust and maturity fears were observed, highlighting the potential impact of animal-assisted therapy on specific psychological factors associated with eating disorders. These findings support the inclusion of dog-assisted interventions as part of multidisciplinary treatment approaches, although further research with larger samples is needed to confirm these effects.

Clinical trial registration: clinicaltrials.gov (NCT04869423).

Background: Perinatal damage to the central nervous system affects both refractogenesis and the formation of central vision in young children. Directly acting on neuronal systems, brain damage can be the main cause of the pathogenesis of mental disorders that can manifest throughout life.

Methods: The methods of neurosonography, computer tomography, magnetic resonance imaging, as well as clinical, psychodiagnostic, and statistical methods were used to study the peculiarities of the psychopathological structure of mental disorders in people with visual impairments due to perinatal pathology.

Results: The severity of obsessive-compulsive disorder (OCD) symptoms showed that 59.4% of the F42 group had moderate symptoms, while 34.8% of the F21 group had serious symptoms (χ2 = 6.154, p = 0.013). Clinical anxiety was significantly more prevalent in the F42 group (53.1%) compared to the F21 group (13.0%) (χ2 = 27.774, p < 0.001), and clinical depression was also more frequent in the F42 group (24%) than in the F21 group (2.9%) (χ2 = 13.846, p < 0.001). A majority of F42 patients (60.4%) rated their quality of life as low, compared to 40.6% in the F21 group (χ2 = 6.324, p = 0.012). Regarding social support, 68.8% of F42 patients received support from family, compared to 49.3% in the F21 group (χ2 = 6.377, p = 0.012).

Conclusions: The obtained data contribute to the development and implementation of the algorithm of differentiated medical and social rehabilitation of patients with visual impairments and mental disorders in order to improve their quality of life.

Objective: This study harnessed cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 2017-March 2020 to examine the relationship between menopausal status and depression among U.S. women.

Methods: Data from NHANES 2017-March 2020 were used for this cross-sectional analysis. Robust statistical approaches, including univariate and multivariate logistic regression, were applied, and subgroup analyses were conducted to assess the stability of the findings.

Results: Women with premature ovarian insufficiency (POI) and early menopause showed a higher likelihood of depression compared with non-menopausal women (POI: odds ratio (OR) = 1.59, 95% confidence interval (95% CI) = 1.07-2.35; Early menopause: OR = 1.71, 95% CI = 1.06-2.76). Among these groups, women whose age at last delivery was under 35 years demonstrated an ever greater vulnerability to depression (POI: OR = 1.62, 95% CI = 1.07-2.43; Early menopause: OR = 1.83, 95% CI = 1.11-3.02). In postmenopausal women, moderate-intensity activity (≥150 minutes per week) was associated with increased odds of depressive symptoms (Overall moderate-to-vigorous physical activity: OR = 1.9, 95% CI = 1.08-3.34; moderate-to-vigorous recreational activity: OR = 2.17, 95% CI = 1.06-4.44). This association was not statistically significant among postmenopausal women engaging in insufficient moderate-intensity physical activity.

Conclusion: These findings support a significant association between POI and early menopause and depression in U.S. women, particularly among those whose age at last delivery was below 35 years.