Actas espanolas de psiquiatria最新文献

Background: The COVID-19 pandemic was a global public health crisis with an unparalleled impact worldwide, presenting a significant challenge for both physical and mental health. The main objective of this study was to analyze the risk of depression during the COVID-19 pandemic and how this was affected by sociodemographic factors, pandemic fatigue, risk perception, trust in institutions, and perceived self-efficacy.

Methods: A cross-sectional study was conducted in the Region of Murcia through two online surveys completed by 1000 people in June 2021 (Round 1) and March 2022 (Round 2). Risk of depression was measured using the 5-item World Health Organization Well-Being Index (WHO-5) questionnaire, and descriptive, bivariate, and multivariate regression analyses were performed to identify factors associated with the risk of depression.

Results: In Round 1, 35.2% of the sample presented a risk of depression, which increased to 39.1% in Round 2. Those at greater risk were women, individuals with lower socioeconomic status, those with less family support, lower trust in institutions, higher perceived risk of contracting the disease, and higher levels of pandemic fatigue.

Conclusions: Identifying vulnerable populations facing mental health issues can help the authorities and institutions that are responsible for managing public health crises to develop and implement inclusive strategies and interventions tailored to the population's needs.

Background: The increasingly fast development of mobile health technologies holds significant value for individuals dealing with mental health conditions. However, inadequate consideration of patients' preferences and expectations undermines real-world outcomes, including sustained adherence. Driven by the belief that specific characteristics, such as youth and higher education, of individuals with obsessive-compulsive disorder make them suitable for digital adoption, we investigated mHealth-related desirability factors within this patient group.

Methods: Fifty-one conveniently selected adults with obsessive-compulsive disorder filled in a self-report questionnaire about symptom self-management preferences, with an emphasis on assessing mobile health options and perceptions of patient-centeredness.

Results: The smartphone phone app emerged as the top choice of most of the sample for receiving information about symptom status (82.4%), obtaining general information about obsessive-compulsive disorder (74.5%), and symptom self-registration (66.7%), with no significant effect of sex or living location. Although only 23.5% of participants were using a health-related app, most expressed interest in using it for receiving symptom management tips (98.1%), medical advice (94.2%), symptom evolution updates (90.2%), lifestyle information (92.2%), medication tracking (88.2%) and short symptom self-reports (90.2%). Median expectations regarding mobile health's impact on patient-centeredness, satisfaction, and adherence were positive or very positive.

Conclusions: Our data confirm that individuals with obsessive-compulsive disorder exhibit strong inclinations and optimistic expectations toward technology-based solutions. We highlight some of the preferences within this patient group, which can inform the design of practical, real-world applications.

Background: Acute ischemic stroke (AIS) is a prevalent and challenging neurological condition associated with high mortality and morbidity rates. This study aimed to evaluate the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with ginkgo diterpene lactone meglumine injection (GDLMI) on cognitive and neurological function recovery in patients with AIS.

Methods: A total of 120 patients with AIS, admitted between January 2021 and January 2022, received rTMS combined with GDLMI after admission. Their cognitive and neurological functions were assessed using the Chinese version of the Montreal Cognitive Assessment (MoCA) and the National Institute of Health Stroke Scale (NIHSS) respectively before and after treatment. Additionally, serum levels of lipoprotein-associated phospholipase A2 (Lp-PLA2) and ischemia-modified albumin (IMA) were quantified. Statistical analyses were performed to elucidate potential correlations between Lp-PLA2 and IMA levels and clinical outcomes.

Results: After treatment, patients with AIS exhibited significantly improved cognitive and neurological functions, increased MoCA score and decreased NIHSS score compared to those before treatment (p < 0.05). A linear correlation was observed between Lp-PLA2 and IMA levels and the recovery of cognitive function in AIS patients (r = -0.892/-0.764, p < 0.05). Before and after factor adjustment, Lp-PLA2 and IMA were identified as independent influencing factors for the efficiency in cognitive function recovery (p < 0.05). Similarly, Lp-PLA2 and IMA levels were linearly correlated with the recovery of neurological function in AIS patients (r = -0.887/-0.796, p < 0.05). Lp-PLA2 combined with IMA performed better than Lp-PLA2 or IMA alone in predicting the efficiency of rTMS plus GDLMI in promoting the cognitive and neurological function recovery (p < 0.05).

Conclusions: rTMS combined with GDLMI can contribute to the cognitive and neurological function recovery in patients with AIS. Serum levels of Lp-PLA2 and IMA could serve as independent influencing factors for the efficiency in promoting cognitive and neurological function recovery.

Background: Hospital readmissions of users with personality disorders are frequent and represent a high personal and economic cost for health systems. This study aimed to identify risk factors associated with readmission in this population, examining sociodemographic and clinical variables.

Methods: A retrospective observational study was conducted, using electronic records. The study was carried out at the Mental Health Hospitalization Unit of the Regional University Hospital of Málaga, covering all admissions between January 1, 2007, and March 31, 2024. Patients with a primary or secondary International Classification of Diseases, 10th Edition (ICD-10) personality disorder diagnosis were included. The dependent variable was hospital readmission, analyzed both at 30 days and at 1 year. Mixed logistic regression models were used to identify risk factors.

Results: A total of 2403 admissions of 1072 individuals for 30-day readmission and 2256 admissions of 1029 individuals for 1-year readmission were analyzed; 17.15% of the admissions resulted in readmission at 30 days, and 42.33% at 1 year. The variables significantly associated with early readmission in the multivariate analysis were younger age (odds ratio (OR) = 0.973, p < 0.001), having a history of previous admissions (OR = 1.900, p < 0.001), and voluntary admission (OR = 1.348, p = 0.033). For readmission at 1 year, the significant variables included younger age (OR = 0.973, p < 0.001), history of previous admissions (OR = 1.956, p < 0.001), having another type of personality disorder diagnosis other than emotionally unstable personality disorder (OR = 0.654, p = 0.006), and comorbidity with affective (OR = 1.726, p = 0.025) and anxiety (OR = 1.915, p = 0.034) disorders compared to no comorbidity.

Conclusions: This study identified key risk factors for hospital readmission of individuals with personality disorders, including younger age, previous admissions, voluntary admission, specific personality disorder types, and comorbidity with affective and anxiety disorders. These findings underscore the need for future research to better understand the risk factors for readmission in this population.

Background: Maintaining good sleep quality is crucial for improving the efficiency of college students. Therefore, this cross-sectional study aims to elucidate the prevalence of sleep disorders among students and analyze its risk factors.

Methods: A cross-sectional study was conducted on college students between March 2022 and December 2022. A well-designed questionnaire was filled out by college students from a certain university in China. Students whose scores on the Pittsburgh Sleep Quality Index (PSQI) scale exceeded 8 were included in the sleep disorder group (SD group), while those with lower were included in the non-sleep disorder group (ND group). Furthermore, single-factor analysis was used to investigate the relationship between general information and sleep disorders. Additionally, multifactor logistic regression was utilized to identify the independent risk factors contributing to the occurrence of sleep disorders among college students.

Results: We observed that the total PSQI score was 7.00 ± 2.17, and the incidence of sleep disorders was 38% among 326 college students. The level of sleep disorders was low (35.89%), scoring 2 or 3 in each component. A high number of students (78.22%) did not use sleep medication in the past 1 month. The level of daytime dysfunction was low (25.76%), scoring 2 or 3 in each section. The differences between the two groups in terms of academic performance, economic level, risk of smartphone addiction, pressure level, family relationship, and physical activity were statistically significant (p < 0.05). Furthermore, multifactor logistic regression analysis indicated that several factors, such as academic performance, smartphone addiction risk, pressure level, and family relationship, were independent risk factors affecting the occurrence of sleep disorders among college students (p < 0.05).

Conclusion: The prevalence of sleep disorders among students in a certain university is 38%. Factors affecting sleep disorders include poor academic performance, high smartphone addiction risk and stress levels, and challenging family relationship.

Background: Schizophrenia (SZ) is a severe mental disorder that is marked by hallucinations and cognitive impairments. Ferroptosis is a type of cell death that is associated with iron and lipid peroxidation; it may play a role in SZ etiology. The present study aimed to explore the correlations between ferroptosis-related genes and SZ in three brain regions.

Methods: We used the Gene Expression Omnibus dataset GSE80655 to analyze brain samples from SZ patients and controls; specifically, we evaluated the anterior cingulate cortex (Ancg), dorsolateral prefrontal cortex (DLPFC), and nucleus accumbens (nAcc). The data were preprocessed in R, and ferroptosis-related differentially expressed genes (DEGs) were identified. Pearson correlation analysis was then performed to assess correlations between these DEGs and age at death, postmortem interval, or brain pH. To identify important ferroptosis-related genes, we created a protein-protein interaction network using the Search Tool for the Retrieval of Interacting Genes/Proteins database, and visualized it using Cytoscape software. Moreover, the pROC package was used to calculate the area under the receiver operating characteristic curves for these important genes. Finally, gene set variation analysis was used for the pathway enrichment analysis of ferroptosis-related pathways, followed by the Wilcoxon rank-sum test.

Results: Nine ferroptosis-related DEGs were upregulated in the Ancg region and one was downregulated in the nAcc region. In the Ancg region, the SZ group had four ferroptosis-related DEGs that were negatively correlated with postmortem interval, and the control group had five ferroptosis-related DEGs that were negatively correlated with brain pH. The protein-protein interaction network analysis of the Ancg region revealed seven significant interacting genes; tissue inhibitor of metalloproteinases 1 (TIMP1) and galectin 3 (LGALS3) were the hub genes. Gene set variation analysis revealed substantial changes in the glycolysis pathway in the Ancg region, and in the glutamate transmembrane transport pathway and unsaturated fatty acid biosynthesis process pathway in the nAcc region, in SZ patients compared with controls.

Conclusions: The correlation between ferroptosis and SZ appears to be stronger in the Ancg than in the nAcc or dorsolateral prefrontal cortex. This association may be mediated by TIMP1 and LGALS3 as well as by the glycolysis pathway, indicating that these might be possible biomarkers for SZ.

Background: Women with binge eating disorder (BED) and bulimia nervosa (BN) usually consume high-calorie meals with variable macro- and micronutrient compositions and have a disturbed perception of gastric fullness. The association of dietary intake with gastric interoception and gastric myoelectric activity (GMA) is poorly studied. This study examined the link between GMA/interoception and dietary intake in women with eating disorders (ED) compared to age/body mass index (BMI)-matched controls.

Methods: A total of 18 women diagnosed with BED (n = 9) or BN (n = 9) and 18 age/BMI-matched controls (MC) group were enrolled in this study. Interoception was measured by measuring the volume of ingested water until the feeling of maximal fullness within 5 minutes (5 min water load test; 5 min WL). GMA was measured using transcutaneous electrogastrography (EGG) before and after water ingestion. Dietary intake was recorded using the multipath 24-hour recall of the two proceeding days. Then, food processor software was used to analyze the macro- and micronutrient composition of their diets. The volume of water load (WL) and the EGG's average dominant frequency (ADF) were correlated with macro- and micronutrient intakes.

Results: Compared to the matched controls, women with ED had a significantly higher consumption of total calories, fat, saturated fat, carbohydrate (CHO), fibers, and sugar, with further higher intakes of total calories and trans-fat in the BED compared to the BN subgroup (p < 0.05). Moreover, the BED group showed higher vitamin B1, copper, and iron intakes than the MC group (p-values were <0.05). The volume of 5 min WL was higher in the BN group than in the control group (697.50 ± 186.45 vs. 466.67 ± 120.44 mL; p < 0.05) and the BED group (697.50 ± 186.45 vs. 488.75 ± 152.17 mL; p < 0.05). In the BED group, ADF showed a significant positive correlation with CHO, sugar, and vitamin B12 intakes (r = 0.700, 0.719, and 0.766, respectively; p < 0.05). Additionally, the 5 min WL volume was negatively correlated with the fiber and sodium intake in the BN group (r = -0.710 and -0.724, respectively; p < 0.05).

Conclusion: Specific dietary approaches might be effective for women with BN and BED. Women with BN may benefit from diets that are higher in fiber and sodium. In contrast, those with BED may find diets rich in simple carbohydrates and vitamin B12 helpful for regulating their eating habits and gastric mobility. Future research is encouraged to test this finding prospectively.

Background: Intracerebral hemorrhage (ICH) is a major cause of morbidity and mortality, often leading to long-term cognitive impairment that significantly diminishes the quality of life. This study investigated the relationship between visceral fat content, obesity-related indicators, and cognitive dysfunction following ICH.

Methods: A total of 388 subjects with ICH who were admitted to the Neurosurgery Department of the Hospital and met the inclusion and exclusion criteria were included in this study. Obesity-related indicators, including body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), were measured. L3 level images were obtained by abdominal computerized tomography (CT). The visceral fat content was estimated using IMAGE J software, and adiponectin levels were assessed via enzyme-linked immunosorbent assay (ELISA). The Mini-Mental State Examination (MMSE) was used to evaluate the cognitive level of patients within 2 weeks of onset, and the shortened version of the Montreal Cognitive Assessment (miniMoCA) was used to evaluate the cognitive level of patients 6 months after ICH. Univariate and multivariate analyses were used to analyze the correlations of BMI, WC, WHtR, abdominal fat, and adiponectin with cognitive impairment after ICH.

Results: BMI, WC, and WHtR were lower in the cognitive impairment group (p < 0.01). Overweight patients exhibited higher MMSE scores than normal-weight patients (p < 0.05) and higher miniMoCA scores than obese patients (p = 0.014). Abdominal obesity, assessed by WC and WHtR, was associated with higher MMSE scores (p = 0.022 and 0.003, respectively). Multivariate analysis indicated that WHtR was associated with cognitive impairment risk post-ICH (odds ratio (OR) = 0.233, 95% confidence interval (CI) (0.071, 0.762); p = 0.016). Although no overall association was found between adiponectin levels and cognitive impairment, subgroup analysis revealed lower adiponectin levels in overweight patients with cognitive impairment (p = 0.040).

Conclusion: WHtR is independently and inversely associated with cognitive impairment after ICH. There is no significant correlation between adiponectin with cognitive impairment after ICH, while subgroup analysis indicates that adiponectin levels are lower in overweight patients with cognitive impairment.

Background: Parkinson's disease (PD), a prevalent neurological condition, is characterized by the progressive degeneration of dopamine-producing neurons, leading to motor dysfunction and non-motor symptoms. Therefore, this study aimed to evaluate the impact of combining levodopa/benserazide with pramipexole on PD patients, focusing on cognitive function, plasma monoamine neurotransmitter levels, and serum growth differentiation factor-15 (GDF-15) and angiopoietin-1 (Ang-1) levels.

Methods: This retrospective study included 120 PD patients admitted to the hospital between January 2021 and January 2023. Based on the treatment approaches, the patients were categorized into the control group (n = 61) and the observation group (n = 59). The control group received oral levodopa/benserazide tablets, while the observation group was treated with levodopa/benserazide tablets combined with pramipexole. The two experimental groups were assessed and compared across several parameters, including PD symptoms [Unified Parkinson's Disease Rating Scale (UPDRS)], cognitive function [Montreal Cognitive Assessment (MoCA)], the levels of plasma monoamine neurotransmitters, and serum GDF-15 and Ang-1 levels.

Results: The response rate to treatment was more significant in the observation group (96.55%) compared to the control group (87.93%, p = 0.162). Post-treatment, both groups demonstrated a decline in their UPDRS and overall scores, with the observation group indicating substantially lower scores than the control group (p < 0.05). Furthermore, both groups showed improvements in MoCA scores, with the observation group exhibiting higher scores than the control group (p < 0.05). Similarly, we observed significantly increased dopamine, 5-hydroxytryptamine, and norepinephrine levels in both groups, with the observation group showing a more pronounced increase (p < 0.05). Additionally, we observed a significant decrease in serum GDF-15 levels and an increase in Ang-1 levels across both groups after treatment. However, the observation group exhibited lower GDF-15 levels and higher Ang-1 levels than the control group (p < 0.05).

Conclusions: The combined use of levodopa/benserazide and pramipexole proves beneficial for managing PD. This therapeutic regimen can improve cognitive abilities and plasma monoamine neurotransmitter levels in PD patients, reduce brain tissue damage and decrease serum levels of GDF-15.

Background: Alzheimer's disease (AD) is a burdening disease and is the main cause of dementia. Quercetin (Que), an antioxidant, plays potential roles in treating age-related disorders, including AD. This study aimed to validate the effects of Que on AD and explore the underlying mechanisms.

Methods: Mice with no treatment, amyloid-β Aβ (1-42) treatment (for acquiring AD model), or Aβ (1-42) plus Que treatment were used. Cognitive function was determined using the open field test (OFT), objective recognition test, and Y-maze test. In brain tissues, mRNA levels of inflammation cytokines, the M1 microglia marker cluster of differentiation (CD)86, and the M2 microglia markers arginase 1 (Arg1) and CD206 were measured. Nuclear factor E2-related factor 2 (NRF2)/heme oxygenase-1 (HO1) pathway-related proteins were detected by western blot. Additionally, mechanisms were investigated using human microglia HMC3 cells treated with Aβ (1-42) and Aβ (1-42) plus Que. The NRF2/HO1 pathway in HMC3 cells was inhibited using the selective inhibitor ML385. Cell viability and death were assessed using the cell counting kit-8 (CCK-8) and lactate dehydrogenase (LDH) release levels, respectively. Cell apoptosis was measured by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL). Levels of NRF2/HO1 pathway-related proteins, inflammation cytokines, and oxidative stress-related markers, including malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione (reduced glutathione (GSH)/oxidized glutathione disulfide (GSSG)), were determined in HMC3 cells. Flow cytometry was used to determine M1 markers CD86 and CD80 and M2 markers CD206 and CD163.

Results: Cognitive ability was impaired in AD model mice, and Que treatment reversed this impairment (p < 0.05). Levels of interleukin (IL)-1β, tumor necrosis factor-alpha (TNF-α), and IL-6 were increased, while M2 markers were decreased in the AD model mouse brain. Que treatment reversed these changes (p < 0.001). The NRF2/HO1 pathway was slightly inhibited in AD mice brain, while further activated by Que (p < 0.05). Que reversed the Aβ (1-42)-impaired cell viability. Through greatly activating NRF2/HO1 pathway, Que suppressed Aβ (1-42)-induced cell death, decreased Aβ (1-42)-promoted IL-1β, TNF-α, IL-6, MDA, CD86 and CD80, increased Aβ (1-42)-suppressed SOD and GSH/GSSG, and greatly increased CD206 and CD163 (p < 0.01).

Conclusion: Quercetin, through the activation of the NRF2/HO1 pathway, promotes M2 polarization of microglia, suppresses Aβ (1-42)-induced inflammation and oxidative stress, protects microglia from Aβ (1-42)-induced damage, improves cognitive function in mice, and demonstrates therapeutic potential for AD.