Actas espanolas de psiquiatria最新文献

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.

Background: Post-stroke depression (PSD) is a common complication, occurring in approximately one-third of these patients. The neurological symptoms of PSD affect patients' daily life and subsequent recovery. Analyzing the pathogenesis of post-stroke depression from a psychological perspective, it was found that PSD patients often feel despair and anxiety, and it is crucial to explore non-pharmacological ways to improve post-stroke depressive symptoms. A combination of exercise and rich environmental stimulation (RES) has been found effective in improving post-stroke depressive symptoms. Therefore, this study aimed to explore the effects of exercise and rich environmental stimulation on PSD in rats and their potential underlying mechanisms and to provide a theoretical basis for managing PSD.

Methods: The PSD rat model was constructed, and the depression-like behaviors of rats in each group were evaluated using the open field test (OFT), sucrose preference test (SPT), and forced swimming test (FST). Moreover, changes in the morphological behavior of rat hippocampus were observed using hematoxylin-eosin (HE) staining and Nissl staining. The expression levels of 5-hydroxytryptamine (5-HT) and norepinephrine (NE) in hippocampus tissues were assessed using enzyme linked immunosorbent assay (ELISA), and the levels of tryptophan-related proteins were determined employing western blot analysis. Additionally, a kynurenine-3-monooxygenase (KMO) inhibitor was administered to the combined stimulation group, and the levels of tryptophan (TRP), 5-HT, kynurenine (KYN), 3-hydroxy-kynurenine (3-HK), and quinolinic acid (QA) were evaluated using liquid chromatography mass spectrometry/mass spectrometry (LC-MS/MS).

Results: Treadmill exercise combined with rich environmental stimulation significantly reduced the immobility time in the FST (p < 0.01), increased the exploratory behavior in the OFT (p < 0.05), and increased the sucrose water consumption in the SPT (p < 0.01), indicating that the depression-like behavior was improved. Treadmill exercise combined with rich environmental stimulation also improved the shape of the damaged hippocampus and increased the number of neurons in the hippocampus. Additionally, treadmill exercise combined with rich environmental stimulation significantly increased the levels of 5-HT and NE in hippocampus tissues (p < 0.01) and decreased KMO protein level (p < 0.01). In the KMO inhibitor group, the neural function was efficiently restored, the levels of 3-HK, QA, and KMO in the hippocampus were substantially reduced (p < 0.01), and the expression level of 5-HT was increased (p < 0.01).

Conclusions: Exercise stimulation combined with enriched environmental stimuli alleviates post-stroke depression in rats, and the underlying mechanisms may be related to TRP/KYN/3-HK/QA excitotoxicity pathways and increased 5-hydroxytryptamine levels.

Background: Post-traumatic stress disorder (PTSD) due to lung cancer seriously affects the mood state of patients. Intensive cognitive management is a structured management method based on cognitive behavioral therapy, which can correct cognitive distortions and regulate adverse emotions. This study mainly explored the effect of intensive cognitive management on the mood state of patients with PTSD due to lung cancer.

Methods: A retrospective analysis was conducted on the clinical data of 169 patients with PTSD due to lung cancer admitted to our hospital from June 2020 to June 2021. Based on different clinical management schemes, these patients were divided into the reference group (RG, n = 87, routine management) and the study group (SG, n = 82, routine management+intensive cognitive management). The sleep status and degree of depression and anxiety were evaluated using the Pittsburgh Sleep Quality Index (PSQI), Self-rating Anxiety Scale (SAS), Depression Scale (D), and Post-traumatic Stress Disorder Check List (PCL).

Results: After 2 weeks (T1) and 4 weeks (T2) of nursing, the scores on the PSQI (p < 0.001), SAS (T0-T1: p < 0.001; T0-T2: p < 0.001) and D (T0-T1: p = 0.026, p < 0.001; T0-T2: p < 0.001), as well as three PCL factors (p < 0.001) of the two groups were significantly lower than those before nursing (T0). At the T1 and T2 stages, difference scores for the PSQI (difference score 1: p = 0.003; difference score 2: p = 0.006), SAS (difference score 1: p = 0.002; difference score 2: p = 0.007), and D (difference score 1: p < 0.001; difference score 2: p = 0.002) were higher in the SG compared with the RG. At the T1 stage, the difference score of the PCL high-alert factor (p = 0.008) was higher in the SG compared with the RG, with no significant difference in difference scores of other two factors (p > 0.05). At the T2 stage, the SG had higher difference scores for the three PCL factors compared with the RG (p < 0.001, p = 0.011, p < 0.001).

Conclusion: Intensive cognitive management can effectively improve sleep quality and adverse emotions and has potential for clinical management of PTSD in patients with lung cancer.

Background: Premenstrual dysphoric disorder (PMDD) represents a significant psychiatric condition affecting women of reproductive age. It is characterized by cyclical emotional and physical symptoms that considerably impair psychosocial functioning. This study aims to investigate the prevalence of PMDD among adult working women and identify associated etiological factors.

Methods: From January 2022 to March 2022, a cross-sectional study utilizing cluster sampling methodology was conducted to investigate the prevalence of PMDD among adult working women in six communities in Hangzhou (China). A total of 1710 participants were selected for research through a questionnaire-based survey. To elucidate the factors associated with PMDD, logistic regression analysis was employed.

Results: Among 1710 working women, 52 had PMDD, representing an incidence of 3.04%. Age (odds ratio (OR) = 3.196, p = 0.002), age at menarche (OR = 0.362, p = 0.011), income (OR = 0.449, p = 0.043), menstrual cycle (OR = 2.352, p = 0.022), menstrual symptoms (OR = 0.317, p = 0.003), physical activity (OR = 2.234, p = 0.028), and caffeine intake (OR = 2.318, p = 0.022) were independent influencing factors of PMDD in adult working women.

Conclusions: The study highlights that PMDD, which has a prevalence of 3.04% in the surveyed population, is a notable concern among adult working women. Key factors, such as age, age at menarche, income level, menstrual cycle characteristics, menstrual symptom presence, physical activity, and caffeine intake, significantly contribute to the likelihood of developing PMDD. These findings underscore the importance of recognizing and monitoring the above risk factors by clinicians to identify and manage PMDD in working women.

Background: Schizophrenia, one of the most disabling disorders worldwide, is characterized by impaired empathy, which appears to be more common in women.

Methods: This study aimed to compare empathy levels between control subjects and patients with schizophrenia by sex. We compared sixty-two patients with schizophrenia and 166 control subjects. All participants completed the Empathy Quotient (EQ) questionnaire. A multivariate analysis of variance model was performed with the EQ as the outcome criterion, and group and sex as fixed factors to test for interaction effects.

Results: Overall, patients obtained lower scores in the cognitive, emotional reactivity and social skills domains of empathy (p < 0.001). No differences between men and women were found and no interaction effect was identified between sex and group (schizophrenia vs. control) (p > 0.05).

Conclusion: This study adds to the evidence on differences in social cognition between people with and without a mental illness such as schizophrenia. It also identifies the absence of sex differences between men and women, observed in both the group of patients and control subjects, which warrants further exploration.

Background: School bullying and depression have a great negative psychological impact on college students, and personality analysis is the key to the detection of psychopathological states. Therefore, this study aimed to explore the mediating effect of personality on depression and school bullying in college students.

Method: This cross-sectional study investigated the bullying situation in colleges and universities by using the Olweus Scale, the Self-Rating Depression Scale (SDS) and the Eysenck Personality Questionnaire. The participants were 1200 college students. Spearman correlation analysis was used to analyze the data and the mediating effect of exposure, and the mediating effect was tested.

Results: Spearman correlation analysis showed that bullying experience was associated with introversion (r = 0.702), neuroticism (r = 0.219) and depressive symptoms (r = 0.600), but was negatively correlated with extraversion (r = -0.537). Depressive symptoms were positively correlated with neuroticism (r = 0.279) and introversion (r = 0.611), but negatively correlated with extraversion (r = -0.469). In relationship between bullying and depression, neuroticism showed positively partially mediating effect and mediating effect ratio was 4.39% (β = 0.161, p < 0.05), and introversion had an obvious mediating effect and the ratio was 40% (β = 0.611, p < 0.001). Otherwise, extraversion partially mediated between campus bullying and depression adversely and mediating ratio is 8.75% (β = -0.359, p < 0.05).

Conclusion: Campus bullying is significantly associated with depression and personality, and personality has a remarkable mediating effect in campus bullying and depression.

Background: Addiction to smartphone is defined as the disability to cease using the device despite the physical, psychological, or social consequences. The diagnosis of this disorder is increasing exponentially among teenagers, even more so after Corona Virus Disease 2019 (COVID-19) pandemic. This study aims to analyze the risk of mobile phone addiction among teenagers in Italy and its relationship with other risk behaviors, such as drug consumption and emotional well-being, following the COVID-19 pandemic.

Methods: A cross-sectional observational study was conducted in Catania, Sicily, during 2022. The study sample comprised 342 students from a secondary education center that answered to a validated Italian version of the Smartphone Addiction Scale Short Version (SAS-SV) accessing through computers and mobile devices. Subjective Wellbeing was measured with the Personal Wellbeing Index-School Children (PWI-SC). Also, they completed the NIAAA Brief Alcohol Use Screener.

Results: Our results showed that 30.1% of students who participated in the survey were classified with a smartphone addiction. Besides, most of the participants used the Smartphone for social networks (86.0%). Regarding the other aspects measured, the mean self-perceived well-being score measured with the PWI-SC was 55.5, and 36.2% of participants were categorized as "high risk" for depression. Finally, four out of ten participants were at "moderate or high risk" of an alcohol use disorder.

Conclusions: Our results suggest that the use of mobile phones is increasing in adolescents, an age group also exposed to social and health problems.

Background: This study aimed to explore the quality of life and anxiety status of patients with ovarian tumor undergoing enhanced recovery after surgery (ERAS).

Methods: This article retrospectively analyzed the clinical data of 300 patients with ovarian tumor admitted in the First Affiliated Hospital of Hebei North University. The patients were divided into two groups according to the perioperative management methods. A total of 156 patients who received traditional perioperative management were included in the control group, and the ERAS group included 144 patients who received traditional perioperative management combined with ERAS management. Quality of life questionnaire-C30 (QLQ-C30) and self-rating anxiety scale (SAS) were used to compare the postoperative quality of life and anxiety status.

Results: The ERAS group showed significantly shorter first feeding time (p < 0.001), exhaust time (p < 0.001) and defecation time (p = 0.002), infusion time (p = 0.026), and hospitalization time (p < 0.001) than the control group. Inter-group comparison showed no significant difference in QLQ-C30 scores in terms of physical (p = 0.345), role (p = 0.509), emotional (p = 0.235), cognitive (p = 0.462), and social functions (p = 0.645) before surgery. The scores of physical, role, emotional, cognitive, and social functions in the ERAS group were significantly higher than the control group after surgery (p < 0.001). There was no significant difference in preoperative anxiety scores between the two groups (p = 0.056). The postoperative anxiety score of the ERAS group was significantly lower than that of the control group (p = 0.002).

Conclusions: ERAS could alleviate the postoperative negative emotions such as anxiety, promote the physical and mental health and improve the quality of life of patients with ovarian tumor.