Actas espanolas de psiquiatria最新文献

Background: Oxytocin (OT) is a key molecule that not only acts as a uterine-contracting hormone during delivery but is also a critical maternal hormone that enables the social transmission of maternal behavior. Postpartum depression (PPD) is a series of depression-like symptoms that occur especially in women in the perinatal period and is accompanied by the failure to adapt to motherhood as well as impaired parent-infant bonding. However, the mechanism by which OT regulates PPD is still unclear. This study aimed to investigate the correlation between OT levels in the paraventricular nucleus (PVN) and PPD and to explore the potential mechanism underlying the involvement of the OT system in the regulation of PPD.

Methods: We induced perinatal chronic stress in pregnant rats to establish a PPD model. OT levels in the cerebrospinal fluid (CSF) and PVN were measured throughout the perinatal period. We administered the chemogenetic virus hM3Dq into the PVN, intraperitoneally injected N-oxyclozapine to activate OT-secreting neurons, and observed the effects of OT treatment on behaviors related to PPD. Finally, we investigated the potential mechanism underlying PPD regulation by the OT system via transmission electron microscopy, immunofluorescence (IF), and quantitative real-time PCR (qRT-PCR).

Results: Compared with those in the normal group, CSF oxytocin levels in the postpartum depression group decreased from late pregnancy to lactation (p < 0.001). Chemogenetic activation-induced endogenous OT release in the PVN not only alleviated PPD-like symptoms in rats but also enhanced the intracellular production of OT. Transmission electron microscopy revealed an increase in the size of the Golgi apparatus, endoplasmic reticulum, and dense vesicles within OT neurons. IF and qRT-PCR revealed elevated OT levels and increased oxytocin expression within the PVN following chemogenetic activation (p < 0.01).

Conclusion: Lower OT levels are strongly associated with the occurrence of PPD. The release of activated OT has been shown to improve PPD-like behaviors in rats and promote intracellular OT synthesis.

Background: Outbreaks of infectious disease represent unique stressors for the general population. In this study, we investigated the prevalence of mental health symptoms and associated risk factors in the general population of China during the Omicron wave.

Methods: We conducted a cross-sectional and large sample online survey during the surge of Omicron cases between 17 December 2022 and 8 January 2023 among Chinese citizens. Then we assessed the prevalence of symptoms of anxiety, depression, insomnia, acute stress disorder, and resilience levels, in the general population of China during the Omicron pandemic by utilizing the coronavirus disease 2019 (COVID-19) anxiety scale (CAS), the Center for Epidemiologic Studies Depression Scale (CES-D), the Insomnia Severity Index scale (ISI), the Stanford Acute Stress Reaction Questionnaire (SASRQ), and the Connor-Davidson Resilience Scale (CD-RISC). Multivariate logistic regression analyses were used to identify demographic and Omicron-related risk factors.

Results: In total, 2800 respondents across 32 provinces and autonomous regions on the Chinese mainland participated in this survey; 1133 (40.5%) were male, and 1860 (66.4%) were 40 years-of-age or younger. The prevalence of anxiety, depression, insomnia, and acute stress disorder was 52%, 58.3%, 45.2%, and 34.8%, respectively. After adjustment for covariates, female gender, a younger age, being unmarried, low income, and a non-medical post were all associated with mental health problems. During the course of infection, participants had a higher risk of developing symptoms of anxiety (odds ratio [OR]: 1.27; 95% confidence interval [CI]: 1.03-1.57; p = 0.028), depression (OR: 1.76; 95% CI: 1.44-2.16; p < 0.001), insomnia (OR: 1.95; 95% CI: 1.57-2.42, p < 0.001) and acute stress disorder (OR: 1.56; 95% CI: 1.25-1.93, p = 0.001). In addition, we found that a lower resilience among participants was associated with a higher risk of anxiety, depression, insomnia, and acute stress disorder (p < 0.001).

Conclusion: Omicron-related stress had a profound effect on the mental health of the general population of China, especially among those infected during the course of coronavirus disease 2019 (COVID-19) and with lower resilience. Our findings suggest that mental health can be improved during a pandemic by increasing resilience.

Objective: To explore the incidence of alcohol use disorder (AUD) after bariatric surgery and the associated risk factors and specific manifestations of increased AUD risk, such as increased alcohol sensitivity and earlier symptom onset.

Methods: This review adhered to PRISMA guidelines. Data were sourced from PubMed, Google Scholar, Cochrane, and Science.gov using search terms related to alcohol, bariatric surgery, and nutrition. Articles were screened based on inclusion and exclusion criteria: Inclusion criteria were English language articles published from 2013-present, availability in full text or open access, and adult patients (≥18 years) who had bariatric surgery. Exclusion criteria were non-English articles, articles written before 2013, unavailable full text or open access, articles that featured pediatric patients or patients who did not use alcohol or had bariatric surgery, and abstracts or opinion pieces. A final total of 11 studies were found.

Data extraction: Studies published from 2013 to the present that involved adult bariatric surgery patients with a history of alcohol consumption.

Results: Findings suggest an elevated risk of AUD post-bariatric surgery, particularly following sleeve gastrectomy or Roux-en-Y gastric bypass surgery. There was strong evidence of increased alcohol sensitivity and AUD symptoms post-surgery, causing potential health effects.

Conclusions: These results underscore the importance of comprehensive preoperative assessments and tailored interventions for bariatric surgery patients with AUD.

Background: Schizophrenia (SCZ) is a chronic mental disorder characterized by severe impairments in the daily functioning and social interactions of the patient. Compared to conventional pharmacological interventions, electroencephalogram (EEG) biofeedback offers stable and sustained effects and reduces susceptibility to relapse. This study aimed to investigate the impact of EEG biofeedback combined with olanzapine (OLZ) on glucose and lipid metabolism, cardiac function, and cognitive ability in SCZ patients.

Methods: A retrospective analysis was conducted on the medical records of 66 SCZ patients who received treatment at Taizhou Second Peoples' Hospital between June 2023 and March 2024. The patients were categorized into groups based on their treatment regimens: a single group (n = 30) and a combined therapy group (EEG biofeedback + OLZ, n = 36). Treatment efficacy and adverse reactions were compared between the groups. Key parameters assessed included glucose and lipid metabolism [total cholesterol (TC), triglyceride (TG), and fasting plasma glucose (FPG)], electrocardiographic (ECG) findings [T-wave changes, ST-segment changes, sinus bradycardia, sinus tachycardia, and other abnormalities], symptom severity [Positive and Negative Syndrome Scale (PANSS)], and cognitive function [Insight and Treatment Attitudes Questionnaire (ITAQ)] before and after treatment.

Results: The total effective rate in the combined therapy group (91.67%) was significantly higher than in the single group (73.33%) (p < 0.05). Post-treatment, both groups exhibited significantly lower TC and FPG levels and higher TG levels compared to pre-treatment values (p < 0.05). However, no significant differences were observed between groups in these metabolic indices (p > 0.05). Similarly, no significant differences in ECG abnormalities were detected between groups, either pre- or post-treatment (p > 0.05). The combined therapy group demonstrated significantly greater improvements in general psychopathological symptoms, positive symptoms, negative symptoms, and PANSS scores, as well as significantly higher ITAQ scores compared to the single group (p < 0.05). The incidence of adverse reactions did not significantly differ between the single group (6.67%) and the combined therapy group (13.89%) (p > 0.05).

Conclusion: EEG biofeedback combined with OLZ improves psychiatric symptoms and cognitive function of SCZ patients compared to OLZ monotherapy. Notably, the combined therapy does not exacerbate ECG abnormalities, metabolic indices, or adverse reactions, indicating a favorable safety profile.

Background: Nasopharyngeal carcinoma (NPC) presents a substantial challenge for patients, impacting their physical and psychological well-being. Patients may experience moderate depression, anxiety, and reduced quality of life due to the disease and its treatments. Therefore, we retrospectively analyzed the adjunctive therapeutic potential of mindfulness-based stress reduction (MBSR) therapy for NPC patients with moderate depression.

Methods: Psychological parameters were assessed using standardized scales, including the Hamilton Depression Scale-17 (HAMD-17), Self-Rating Depression Scale (SDS), Perceived Social Support Scale (PSSS), the Short-From-12 Health Survey (SF-12), and Mindfulness Attention Awareness Scale (MAAS). Statistical analyses were performed to compare the two groups.

Results: A total of 131 patients including 67 patients with control group and 64 patients with Mindfulness-Based Stress Reduction therapy group were included. After 8 weeks of treatment, the MBSR therapy group showed significant improvements in psychological parameters, including depression, anxiety, perceived stress, quality of life, and mindfulness attention awareness (p < 0.05), compared to the control group. Additionally, the MBSR therapy group reported significantly higher overall satisfaction with treatment, willingness to recommend treatment, and perceived benefit from treatment (p < 0.05).

Conclusion: The study findings support the adjunctive therapeutic value of MBSR therapy in improving psychological outcomes and patient satisfaction among individuals with NPC-induced moderate depression.

Bipolar disorder (BD) is characterized by the occurrence of manic/hypomanic and depressive episodes, with the latter having a significant impact on morbidity, mortality and overall quality of life. Current guidelines for bipolar depression provide limited treatment options, with only a few approved therapies. Despite these limitations, approximately 50-60% of individuals diagnosed with BD are prescribed antidepressants. However, the use of these medications remains controversial due to risks of manic induction, rapid cycling, and symptom destabilization. This review explores the neurotransmitter mechanisms underpinning the phases of BD, focusing on monoamines and assessing the efficacy and safety of different antidepressant medications in the treatment of bipolar depression. Norepinephrine and dopamine have been identified as neurotransmitters associated with both depressive and manic poles, with a proposed deficit in depression and an increase in mania. The evidence indicates that serotonin is deficient during depressive phases, yet its imbalance also manifests in mania. Selective serotonin reuptake inhibitors (SSRIs), which primarily increase serotonin levels, are generally safer than tricyclic antidepressants (TCAs) and show promising-though not definitive-results, especially when combined with mood stabilizers. Other newer-generation antidepressants may also have potential for the treatment of bipolar depression. The heterogeneity of mood disorders poses a significant challenge in the diagnosis of BD, which is often ambiguous and complex. The natural mood fluctuations associated with BD, in conjunction with the frequent comorbidities such as anxiety, render the treatment of this condition particularly challenging, particularly in the context of antidepressant therapy. While clinical trials are conducted with the utmost rigor, they frequently fail to account for the intricacies of the real-world context due to the strict inclusion criteria. The identification of predictors of effective antidepressant use, such as symptom severity and comorbid conditions, has the potential to enhance treatment outcomes. Future research should aim to identify individualized predictors and deepen understanding of mood disorder spectra to optimize antidepressant use in bipolar depression.

Background: Psychomotor agitation is a common psychiatric disorder that often requires physical restraint, consuming significant healthcare resources. Assessing the clinical importance of the correct method of physical restraint for patients with psychomotor agitation presents a challenge for physicians and researchers. This review aims to assess the use of physical restraints in Intensive Care Units (ICUs) and other departments, identifying potential factors influencing their use.

Methods: Two independent researchers conducted a computerized search of PubMed, Embase, Web of Science, and Cochrane databases for literature related to methods of psychomotor agitation restraint. The review focused on the methods of inhibiting psychomotor agitation in the ICU.

Results: A total of seven papers met the inclusion criteria for this systematic review. The restraint rates among patients ranged from 8.7% to 59.07%. Factors influencing patient restraint included gender, marital status, mental and behavioral disorders, emergency referrals, and the use of mechanical ventilation.

Conclusions: Restraint is frequently used among patients, particularly among the elderly, males, and those with disorders of consciousness or social relationship issues. This review identifies several factors influencing restraint rates in patients with psychomotor agitation, highlighting the need for further research to develop targeted interventions aimed at reducing the necessity for physical restraints.

Background: Alzheimer's Disease (AD) affects millions of elderly individuals worldwide and has been clinically recognized as one of the most significant disorders compromising quality of life in late-stage human development. The objective of this study is to systematically evaluate the influence of holistic nursing (HN) on patients with AD, thereby providing evidence-based references for clinical practice.

Methods: A total of 105 patients with AD hospitalized in our hospital between January 2023 and January 2024 were enrolled for prospective analysis. Among them, 58 received conventional care (control group), and 47 received HN (observation group). Before and following the nursing interventions, both groups underwent assessment using the Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog), Montreal Cognitive Assessment (MoCA), and Self-rating Anxiety/Depression Scales (SAS/SDS). In addition, neurotransmitter levels and neuroinflammatory markers were measured using enzyme-linked immunosorbent assay and fully automated chemiluminescent immunoassay. Treatment compliance, incidence of adverse events, and family satisfaction were also recorded and compared between the two groups.

Results: After nursing interventions, the observation group demonstrated significantly higher MMSE and MoCA scores compared to the control group. Conversely, NPI, ADAS-cog, SAS, and SDS scores were notably lower in the observation group (p < 0.05). Furthermore, neurotransmitter levels were significantly elevated in the observation group, while the concentrations of central nervous system-specific protein β (S100β) and interleukin-1β (IL-1β) were significantly reduced (p < 0.05). Although the incidence of adverse events did not differ significantly between the two groups (p > 0.05), the observation group exhibited higher treatment compliance and greater family satisfaction (p < 0.05).

Conclusion: HN effectively improves cognitive function and alleviates psychiatric symptoms in AD patients, supporting its recommendation for clinical application.

Clinical trial registration: No. NCT06868004.