Actas espanolas de psiquiatria最新文献

Background: Amisulpride is a novel atypical antipsychotic (AAP) with slower absorption, metabolism, and excretion in females, potentially leading to elevated plasma concentrations. This study aimed to explore the correlation between serum amisulpride levels and therapeutic efficacy, glycolipid metabolism and side effects in adult female patients with schizophrenia (SCH).

Methods: A retrospective study was conducted involving 122 adult female SCH patients admitted to the Third People's Hospital of Yongkang between January 2020 and January 2022. Fasting venous blood samples were collected at baseline and 1, 2, 4 and 8 weeks post-treatment with amisulpride. Key parameters measured included serum amisulpride concentration, Brief Psychiatric Rating Scale (BPRS) scores, fasting blood glucose, total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and side effect scores.

Results: Serum amisulpride levels significantly increased at 2, 4, and 8 weeks compared to the first week (p < 0.05), while BPRS scores significantly decreased at all time points compared to those before treatment (p < 0.05). A strong negative correlation was observed between amisulpride concentration and BPRS scores (r = -0.948, p < 0.001). Significant alterations in fasting blood glucose, TC, TG, HDL, and LDL levels were observed post-treatment (p < 0.05). Serum amisulpride concentration negatively correlated with fasting blood glucose, TC, and LDL (r = -0.622, -0.160, -0.796, respectively, p < 0.001) and positively correlated with TG (r = 0.447, p < 0.001). Side effects scores increased significantly after 2, 4, and 8 weeks compared to the first week (p < 0.05), with amisulpride concentration positively correlating with side effects scores (r = 0.739, p < 0.001).

Conclusion: Serum amisulpride levels in female SCH patients are closely correlated with therapeutic efficacy, glycolipid metabolism and incidence of side effects, respectively. Monitoring serum concentrations may provide valuable insights for guiding personalized medication management and optimize treatment outcomes.

Background: Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) represent early clinical manifestations of Alzheimer's disease (AD). Recent research has highlighted serum markers and changes in brain structure as promising tools for diagnosing cerebral disorders. This study investigated serum biomarkers and brain structural changes in the early clinical stage of AD affected individuals residing in a cold region.

Methods: Clinical data from patients with SCD or MCI and from normal controls, who were tested at Hongqi Hospital Affiliated to Mudanjiang Medical College from January 2018 to December 2023, were retrospectively analysed. According to clinical classification, the patients were categorised into SCD (n = 60), MCI (n = 60) and normal control groups (n = 70). The magnetic resonance imaging data, serum levels of amyloid β 1-40/42, exosomal miRNA (34a/34c/135a) and apolipoprotein E (ApoE) genotype were collected and analysed.

Results: The mean diffusivity values in the bilateral parahippocampal gyrus, inferior longitudinal bundle, right inferior fronto-occipital tract and posterior cingulate gyrus in the SCD group decreased relative to those of the MCI group (all p < 0.05). Conversely, the fractional anisotropy values in the bilateral parahippocampal gyrus, inferior fronto-occipital tract, inferior longitudinal tract and posterior cingulate gyrus in the SCD group increased (all p < 0.05). Compared with the normal control group, the MCI and SCD groups showed elevated levels of serum Aβ1-40 and Aβ1-42 and exosomal miRNA-34a and miRNA-34c (all p < 0.05) and decreased exosomal miRNA-135a expression (p < 0.05). The serum levels of Aβ1-40, Aβ1-42 and exosomal miRNA-34a and miRNA-34c in the SCD group were lower than those in the MCI group (all p < 0.05), whereas miRNA-135a level was higher (p < 0.05). The proportions of ApoE ε3/3 in the normal control group was the highest (62.86%), and the proportions of ApoE ε2/4, ε3/4 and ε4/4 in the MCI group were the highest (38.33%, 26.67% and 10.00%, respectively).

Conclusion: Changes in brain structure and serum biomarkers (miRNAs and Aβ) are evident in the early stages of AD, and the proportion of ApoE alleles vary in early AD. These findings may contribute to the development of an early recognition model for AD.

Background: Physical exercise may confer benefits on cognitive function and quality of life in children with autism spectrum disorder (ASD). However, the evidence has not been co mprehensively synthesized. This study aimed to investigate the effect of exercise intervention on cognitive function and quality of life with ASD, and provide evidence to support the scientific use of exercise interventions in practice.

Methods: We systematically searched major databases from inception to November 2023 for randomized trials and observational studies examining exercise interventions in children with ASD. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity was assessed using the I2 statistic. Risk of bias was evaluated with the Cochrane tool.

Results: Fourteenth studies were included. Meta-analysis of 8 randomized trials found a small but significant effect of exercise on social communication (MD: 1.42, 95% CI: 0.21 to 2.6322, p = 0.02, I2 = 29%). The effect on social cognition was also significant (MD: 1.99, 95% CI: 0.18 to 3.80, p = 0.03, I2 = 0%). Influential analysis identified 2 studies as outliers. Leave-one-out analysis showed meta-analysis conclusions were robust. The included studies consistently demonstrated benefits of exercise on sleep, behavioral aspects, motor skills, quality of life, and other outcomes.

Conclusions: This meta-analysis provides evidence that exercise interventions may improve core symptoms and functional outcomes in children with ASD. However, small sample sizes and heterogeneity indicate cautious interpretation. Further adequately powered trials are needed to establish optimal exercise programs for managing ASD.

Background: Patients with severe mental illness (SMI) have a life expectancy that is 15 to 20 years shorter than that of the general population primarily due to cardiovascular disease (CVD), which is a leading cause of mortality. Contributing factors include unhealthy lifestyles, physical inactivity, diet, smoking, specific medications, and obesity. This study seeks to describe risk factors and cardiovascular risks (CVR) among hospitalized patients with SMI at a specialized mental healthcare center.

Methods: This retrospective study analyzed demographic and clinical data from hospitalized patients between January and December 2022. The Framingham 10- and 30-year risk scores were used to assess CVR, and logistic regression was employed for statistical analysis to compare results and determine significant differences.

Results: The study consisted of 366 patients, of whom 47.2% were women, aged 18 to 81. Women were, on average, older than men, with mean ages of 44.7 and 37.8 years, respectively (p < 0.001). Additional demographic characteristics show that 54.9% had finished high school and 81.1% were single. The biggest CVR factors in our sample were female sex, higher academic level, systolic blood pressure above 150 mmHg, triglyceride levels above 150 mg/dL, fasting glucose values above 100 mg/dL, cigarette smoking, and a family history of CVD.

Conclusions: The research shows an incidence of CVD risk among patients with SMI. Multiple lifestyle and medical factors correlate with an increased mortality risk over 10 and 30 years. These findings highlight the need to control modifiable risk factors such as blood pressure (BP), serum lipids, glucose levels, smoking habits, and possible medication side effects to positively impact survival and quality of life in this group.

Background: Workplace mobbing affects approximately 20% of workers worldwide, yet about 70% of victims do not report it, limiting the full understanding of its true impact. While previous research has established its association with mental health disorders, the broader burden-including burden of disease (BOD), cost of illness (COI), and productivity loss (PL)-remains underexplored. This scoping review aims to address this gap by mapping the existing literature on the BOD and economic costs associated with mobbing-related mental health disorders.

Methods: We conducted a scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A systematic search in National Library of Medicine's bibliographic database (MEDLINE), Latin American and Caribbean Literature in Health Sciences (LILACS), Embase, Scopus, and PsycInfo databases (until June 30, 2021) identified primary studies and reviews assessing BOD, COI, or PL in adults exposed to workplace mobbing. Articles were screened independently by two reviewers in two phases (title/abstract and full-text review). Data extraction focused on study characteristics and key findings, which were categorized into predefined thematic domains.

Results: Fourteen studies published between 2008 and 2020 met the selection criteria (71.4% primary studies, 28.6% reviews). The definition of mobbing varied across studies, and frequently, different terms were used interchangeably. None of the included studies quantified disease burden using standard metrics such as disability-adjusted life years (DALYs). Instead, PL was assessed indirectly through absenteeism, presenteeism, and work performance assessments.

Conclusions: Mobbing is a significant occupational health issue with substantial mental health implications, yet research on its economic and disease burden remains limited. The heterogeneity in definitions and methodologies across studies hampers comparability and synthesis. Future research should adopt standardized definitions and employ robust burden-of-disease frameworks, such as DALYs and Quality-Adjusted Life Years (QALYs), to better quantify the impact of mobbing on mental health and work productivity.

Background: Currently, the factors impacting postpartum post-traumatic stress disorder (PP-PTSD) remain unclear. Therefore, this study aimed to screen the PP-PTSD risk factors and to develop an effective and user-friendly column chart prediction model (nomogram), thereby providing a basis for early clinical diagnosis and prompt intervention.

Methods: This retrospective study collected 180 postpartum women between January 2023 and December 2023. Based on the occurrence of PP-PTSD, study participants were divided into two groups: a control group (No-PP-PTSD) and an observation group (PP-PTSD). The logistic regression analysis were used to identify independent risk factors for this condition, and nomogram models were developed by incorporating these items. Furthermore, we applied the calibration plots, decision curve analysis (DCA), and receiver operating characteristic (ROC) curve to assess the predictive performance of the nomogram.

Results: Multivariable logistic regression analysis identified working condition (p = 0.008), relationship with the second primary caregiver of the child (p < 0.001), type of pregnancy (p < 0.001), pregnancy mode (p < 0.001), newborns sent to the ICU (p < 0.001), postpartum anxiety (p = 0.002), and plan pregnancy (p = 0.001) as independent risk factors for PP-PTSD.

Conclusions: We developed a user-friendly and scientifically robust nomogram model for predicting PP-PTSD risk in postpartum women. This predicting tool has the potential to assist clinicians in making informed decisions concerning PP-PTSD among postpartum women.

Background: A decreased quality of life is commonly observed in elderly patients with prostate cancer (PCa), and psychological changes in these patients require particular attention. This study aimed to investigate factors influencing depression, death anxiety, and quality of life in elderly PCa patients and to explore the mediating role of depression in the relationship between death anxiety and quality of life.

Methods: A total of 120 valid questionnaires from PCa patients at Lu'an Hospital of Anhui Medical University were collected between October 2021 and July 2024. The Templer Death Anxiety Scale (T-DAS), Zung Self-Rating Depression Scale (SDS), and Functional Assessment of Cancer Therapy for PCa (FACT-P) were used to assess death anxiety, depression, and quality of life, respectively. Influencing factors and the mediating role of depression between death anxiety and quality of life were analyzed.

Results: (1) Patients had a mean SDS score of 56.93 ± 4.47, T-DAS score of 44.83 ± 7.18 and FACT-P score of 103.52 ± 6.22; (2) Univariate analyses showed that patients' depression levels were associated with occupational status, average monthly income, length of illness, primary caregiver, and number of chronic illnesses (p < 0.05); death anxiety levels were associated with age, length of illness, primary caregiver, and number of chronic illnesses (p < 0.05); and quality of life was associated with age, BMI, and number of primary caregivers and chronic illnesses (p < 0.05); (3) Correlation analysis showed that depression was negatively correlated with quality of life (ρ = -0.360, p < 0.001), death anxiety was negatively correlated with quality of life (ρ = -0.456, p < 0.001), and death anxiety was positively correlated with depression (ρ = 0.493, p < 0.001); (4) Death anxiety had a significant negative effect on quality of life, with a direct effect of -0.262 and a total effect of -0.429. Depression significantly mediated the relationship between death anxiety and quality of life, with a mediating effect of -0.167 (95% CI: -0.331 to -0.045).

Conclusion: Depressive symptoms and death anxiety are prevalent among elderly PCa patients. Death anxiety directly impacts the quality of life of patients and also mediates an indirect effect through depression, further reducing patients' quality of life.