Actas espanolas de psiquiatria最新文献

Background: University life is a phase of developing personal and professional skills, but it brings challenges such as distancing from family and supporting networks, difficulties with academic tasks, loneliness, new relationships, competitiveness, and social, socioeconomic, and psychological vulnerability, among others. These conditions can lead to the development of illnesses such as anxiety, depression, sleeping disorders, suicide, self-harming, and excessive drug use, including psychotropic medications. Therefore, this study aimed to evaluate the use of psychotropic medications and its association with sociodemographic, academic, behavioral, and health variables in Brazilian university students.

Methods: A cross-sectional, quantitative research, with a sampling of 524 students from a Brazilian public Higher Education Institution (Federal University of Mato Grosso - UFMT). The collection took place from October 10th to December 30th, 2022. An online questionnaire was applied with sociodemographic and clinical questions-the General Anxiety Disorder Questionnaire-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9). The data were descriptively and inferentially analyzed; in the descriptive analysis, the absolute (FA) and relative (FR) frequencies of each category investigated were presented; and for bi- and multivariate analyses, Poisson regression with robust estimation was used.

Results: The participants were at the median age of 22 years old, the majority were female (69.7%), heterosexual (68.1%), with medium/high subjective social status (82.4%) and without being involved in a romantic relationship (54%). The prevalence of psychotropic medication use was 26.1%, considering that 17.5% was not prescribed by a medical professional. The most used class of medications was antidepressants (91 participants), followed by natural medicines (38 participants). Among the segments associated with the use of psychotropic drugs were female individuals, romantic relationships, perception of academic performance by postgraduate students, and previous diagnoses of mental or mood disorders (depression and anxiety).

Conclusions: The results obtained highlight the importance of research on mental health among university students, especially regarding the use of psychotropic drugs, which must be monitored by a qualified professional. At the university, these data can be important for the development of policies aimed at health and life quality, in addition to contributing to the strengthening of national and international partnerships, and promoting the scientific production in the area.

Background: Liquid-liquid phase separation (LLPS) has been increasingly recognized as a crucial mechanism in the pathogenesis of various neurodegenerative disorders, including Alzheimer's disease (AD). There remains a paucity of effective diagnostic biomarkers for this condition. This study aims to develop and validate a novel LLPS-related molecular signature to enhance the diagnostic accuracy and early detection of AD.

Methods: LLPS-related genes were identified from online databases and subjected to bioinformatic analyses, including protein-protein interaction (PPI) network analysis and least absolute shrinkage and selection operator (LASSO) regression. Based on the optimal LLPS-related genes, a diagnosis risk model was constructed, and the diagnostic ability was evaluated using a receiver operator characteristic (ROC) curve. To elucidate the biological functions of the identified LLPS-related genes, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were conducted.

Results: A total of 149 LLPS-related genes were screened, which were found to be involved in functions related to oxidative stress, apoptosis, and cancer progression. The 149 genes were refined to six optimal candidates through PPI network analysis and LASSO regression: Activator of HSP90 ATPase Activity 1 (AHSA1), Eukaryotic Translation Initiation Factor 2 Alpha Kinase 2 (EIF2AK2), Heat Shock Protein Family A (Hsp70) Member 4 (HSPA4), Notch Receptor 1 (NOTCH1), Superoxide Dismutase 1 (SOD1), and Thioredoxin (TXN). Based on the six optimal genes, a diagnostic risk model was constructed, and the diagnostic ability was verified to be promising in AD both in training, internal validation, and two external validation datasets, with area under ROC curve (AUC) above 0.8. Furthermore, significant correlations were observed between the expression of these genes and tumor immune cell infiltration.

Conclusions: A six-gene diagnosis model was constructed and verified to exhibit robust diagnostic ability in AD.

In Spain and many other countries, psychotherapy training is heterogeneous and not very evidence-based. This contribution addresses related ethical, normative and legal issues with the aim of clarification, as well as certain relevant aspects of psychological work in the field of mental and behavioural health in Spain. It will analyse professional responsibility and possible intrusiveness in the clinical-psychological field. The authors have scrutinised national legislation along with PubMed/Medline content, as well as a wide variety of scientific papers collected using the search engines Google Scholar and Scientific Electronic Library Online. For clinical psychologists and psychiatric doctors, when appropriate, it is their professional responsibility to choose among the various and sometimes conflicting interventions proposed as the most appropriate or priority psychotherapies. Psychotherapy, as a treatment, although not regulated, should only be undertaken by health personnel who are suitably qualified in mental health with the guarantee of the State, at least in Spain. This would probably help to mitigate the perennial crisis of replication in psychology, particularly as applied to mental health. Likewise, it is a relevant and popular issue, antagonistic to intrusiveness, that any common intervention of interpersonal psychic help should be considered therapeutic, or preferably be undertaken by personnel with a degree in psychology. There is no mandatory psychotherapeutic standard for clinical psychologists and psychiatrists, nor is there an official common international system of accreditation in clinical psychology outside Spain. In the field of mental health, any intervening psychologist, like any medical doctor, is ethically and legally responsible for their actions, omissions and consequences.

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.

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.

No abstract present.

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.