Actas espanolas de psiquiatria最新文献

Background: Current research on An Shen Jiao Tai Yi Zhi decoction remains limited, highlighting the need for further investigation to validate its therapeutic efficacy and elucidate its underlying mechanisms of action. A study was conducted to evaluate the effects of An Shen Jiao Tai Yi Zhi decoction on sleep disorders in patients with Parkinson's disease.

Methods: The study population comprised 85 patients diagnosed with Parkinson's disease and sleep disorders at the Department of Encephalopathy of Hebei Provincial Hospital of Traditional Chinese Medicine, between January 2021 and December 2023. In accordance with different treatment methods, they were divided into the Western medicine group (n = 45, conventional Western medicine treatment plus pramipexole hydrochloride) and the traditional Chinese medicine group (n = 40, An Shen Jiao Tai Yi Zhi decoction based on the Western medicine group). To minimize selection bias, propensity score matching (PSM) was employed with a 1:1 ratio, yielding 20 cases in the traditional Chinese medicine group and 20 cases in the Western medicine group. Clinical data, total effective rates, Epworth Sleepiness Scale (ESS) scores, sleep architecture parameters, homocysteine levels, interleukin-1β concentration, and adverse reactions were collected for all participants. Baseline characteristics were balanced between the two groups through PSM. The data were analyzed using t-test, chi-square test, and analysis of variance.

Results: PSM matching was performed in a ratio of 1:1, and a total of 40 patients were divided into two groups. No significant differences in clinical characteristics were observed between the groups. The total effective rate of the traditional Chinese medicine group was higher than that of the Western medicine group (p < 0.05). Before the intervention, no differences in ESS score, sleep architecture, and related factors were found among the two groups (p > 0.05). After 14 days of intervention, the traditional Chinese medicine group exhibited significantly greater improvements across all measured indicators compared to the Western medicine group (p < 0.05). Notably, there were no significant differences in the incidence of adverse reactions between the two groups (p > 0.05).

Conclusions: An Shen Jiao Tai Yi Zhi decoction demonstrates significant therapeutic efficacy, exhibiting anti-inflammatory properties and promoting changes in sleep architecture, with minimal adverse effects.

Background: Attention Deficit/Hyperactivity Disorder (ADHD) is the most common neurodevelopmental disorder. The affectation of executive functions is stressed in the most recent research on ADHD, and many tests are used to assess it in ADHD, but they are usually time- and effort-consuming.

Methods: From a database of a total of 222 children with ADHD, 59 of them suffering executive dysfunction, we took the most widely used tests for executive functions in ADHD (Behavior Rating Inventory of Executive Function (BRIEF), Swanson, Noland, and Pelham (SNAP)-IV, and Conners' Parent Rating Scale (CPRS-R)) and applied several methods of test shortening: Item-total correlations from the Classical Test Theory, factor analysis and their subsequent factor loadings, elastic nets, and the Graded Response Model from the Item Response Theory models. Using the parameters or indicators provided by each of these methods, we selected the most discriminative items to develop a brief screening tool.

Results: Our results show that different selection methods select different items. More importantly, we found that the shortened tests obtained this way are in general capable of discriminating between patients with and without ADHD. More precisely, all the shortened tests show high sensitivity, but relatively low specificity.

Conclusions: Shortened tests can be used for screening purposes without having to administer full test versions.

Background: Recent studies on transdiagnostic processes consider eating disorder (ED) examples of psychological inflexibility. To date, the instrument most widely used to evaluate self-concealment is the Self-Concealment Scale (SCS), although there is as yet no Spanish adaptation of the instrument. The objective of this study was to adapt and study evidence of validity of the SCS to the adolescent population in Spain.

Method: A sample of 230 Spanish adolescents aged 13 to 19 years (Mean (M) = 15.52; Standard deviation (SD) = 1.13) was used to study the psychometric properties of the SCS. The discriminative capacity of the items was analyzed, their unidimensional factorial structure was confirmed, the reliability of the scores was studied, and evidence of validity in relation to other clinical variables was examined.

Results: As in the original scale, confirmatory factor analysis showed adequate fit of the 10-item one-dimensional model (Standardized Root Mean Square Residual (SRMSR) = 0.05; comparative fit index (CFI) = 0.90). Body image inflexibility, and to a lesser extent, self-concealment, explained 52.2% of the variance in risk of ED.

Conclusions: It was concluded that the Spanish version of the SCS has adequate psychometric properties and may be a useful tool in evaluating risk of ED in adolescents.

Poor adherence to antipsychotic treatment is the main reason for relapse and admission in patients with severe mental illness (SMI). In addition to apprehensions about side effects, factors for non-adherence include the stigma of mental illness, which also extends to its treatment and which is further compounded by negative perceptions of antipsychotics within the medical profession itself. By reinforcing misconceptions around antipsychotics, warnings at the outbreak of pandemic associating antipsychotic use with coronavirus disease 2019 (COVID-19) related risks could have discouraged antipsychotic prescribing when it was otherwise indicated and also disrupted adherence of SMI patients to the treatment they need. Several studies on risk of antipsychotic use during the pandemic adopted inappropriate inclusion criteria and reached conclusions that proved misleading, particularly if applied to SMI patients. Methodological flaws included ill-defined cohort groups and not accounting for adherence to treatment or clinical indication for antipsychotic prescribing. Conversely, reports from the clinical setting, which were later corroborated in clinical studies, have shown that adherence to antipsychotics may actually protect from COVID-19, thus indicating that the benefits of adhering to antipsychotic treatment extend beyond controlling psychotic symptoms alone. Evidence emerging from the COVID-19 experience adds to the view that adherence to second generation antipsychotics in SMI offers a therapeutic effect to both mental and physical health. This validation of modern antipsychotics as a vital medical asset can prove a turning point in the fight to dispel the stigma of SMI and its treatment.

Background: Attention deficit hyperactivity disorder (ADHD) refers to a set of symptoms, such as an inability to sustain attention, hyperactivity, and impulsivity, with a prevalence of 2.0% for the general population. Approximately 2.7% of American medical students report having some form of disability, with ADHD emerging as the most frequently self-disclosed condition. Medical students with a positive ADHD Self-Report Scale (ASRS) score present more depression symptoms in comparison with those with a negative ASRS score. Previous studies suggest that a low amount of time spent in physical activity and a high amount of time spent in sedentary behavior were associated with mental disorders (e.g., anxiety and depression). However, information in the literature on this association with symptoms of ADHD is limited, particularly in medical students.

Methods: In this cross-sectional study, we investigated a sample of medical students aged 18 years or older. Individuals diagnosed with ADHD were excluded. Participants completed an online survey, which included questions about demographic and academic experiences, the ADHD Self-Report Scale, the International Physical Activity Questionnaire (IPAQ), and the Beck Anxiety Inventory (BAI). Statistical analysis was conducted using the SPSS 22 program, with a significance threshold of p = 0.05.

Results: Out of ninety-nine medical students included, forty individuals (40.4%), demonstrated positive ASRS scores, suggesting a risk for ADHD. After dividing the participants into groups according to their ASRS scores (negative or positive ASRS), the Mann-Whitney comparison revealed that the negative ASRS group exhibited lower daily screen time (9.0 vs 12.0 hours per day; p < 0.01) and reduced anxiety symptoms (8.0 vs 16.0 points; p < 0.01) compared to the positive ASRS group. Furthermore, the linear multiple regression analysis indicated that screen time was a predictor of the ASRS score.

Conclusion: In a sample of medical students, the current study showed a prevalence of 40.4% of positive ASRS. The results suggest that medical students with a positive ASRS score have higher screen time, as well as more symptoms of anxiety. In addition, we found that screen time was a significant predictor of scores in the ASRS.

Objective: Surgery, as the preferred option to extend the survival of breast cancer patients, has increasingly garnered attention for its impact on patients' mental status and quality of life (QoL). Therefore, this study aimed to identify the factors affecting the QoL and mental status of breast cancer patients with schizophrenia, thus enabling subsequent interventions to improve their mental status and QoL.

Methods: This study included 125 breast cancer patients with schizophrenia, and their mental status and QoL were analyzed before and after surgery. The mental status of these patients was assessed using the Symptom Checklist-90 (SCL-90), and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) was used to score their QoL. Baseline characteristics were recorded, including age, marital status, education level, and per capita monthly household income. The clinical and demographic data were statistically analyzed to identify factors affecting patients' mental status and QoL.

Results: We observed that the mental status and QoL of breast cancer patients with schizophrenia at preoperative and postoperative stages were influenced by marital status, education level, tumor stage, tumor size, and monthly family income. Additionally, the type of surgery was significantly associated with postoperative mental status and QoL and was found to be a predictor influencing the overall QoL. Furthermore, surgery had a positive impact on patients across different treatment stages.

Conclusion: The psychological state and QoL of breast cancer patients with schizophrenia are influenced by various factors at different stages of treatment (preoperative and postoperative). Surgery significantly improves the patients' psychological state and QoL.

Aim: This report presents the case of a 56-year-old female, initially diagnosed with an eating disorder, who was ultimately found to suffer from Addison's disease. The aim is to highlight the differences between these two conditions to prevent future misdiagnoses.

Case presentation: The patient was admitted to the hospital under the care of the Internal Medicine Department due to an electrolyte imbalance. Following consultations with Psychiatry and Endocrinology, further evaluations led to the diagnosis of adrenal insufficiency. This case prompted a review of the literature on this topic. A comprehensive PubMed search identified nine published case reports of patients with adrenocortical insufficiency who were initially misdiagnosed with an eating disorder.

Result: The data from these 10 cases, including the present one, were analyzed in terms of age, sex, diagnostic delay, symptoms, laboratory abnormalities, and clinical outcomes.

Conclusions: Addison's disease is a rare and potentially fatal condition whose symptoms can sometimes be mistaken for those of an eating disorder. It is crucial for psychiatrists and other specialists to consider this differential diagnosis in similar clinical presentations.

Background: Asthma is a common chronic respiratory disease that severely affects children's health and leads to anxiety and depressive symptoms. Therefore, this study aims to investigate the correlation between asthma control status and depressive symptoms in children with asthma.

Methods: This study included pediatric asthma patients (n = 117) who were admitted to Jiaozhou Central Hospital of Qingdao between January 2021 and January 2023. Based on asthma control status, the patients were divided into well-controlled (n = 67) and poorly controlled (n = 50) groups. Various parameters, including asthma control, depressive symptoms, respiratory function, sleep quality, physical activity, and quality of life, were assessed through standardized assessments, medical records, and participant, or caregiver reports. The data was comparatively analyzed between the two groups.

Results: We observed no significant differences in baseline characteristics between the two experimental groups (p > 0.05). Furthermore, the well-controlled group demonstrated better asthma control with lower hospitalizations, emergency visits, and higher asthma control test scores (p < 0.001). Additionally, the well-controlled group exhibited better respiratory function with higher forced vital capacity (FVC), better ratio of forced expiratory volume in one second to forced vital capacity, higher maximal mid-expiratory flow, higher forced expiratory flow between 25%-75% of FVC, and higher total lung capacity (p < 0.001). Moreover, the symptom score (p < 0.001), activity restriction score (p = 0.001), and affective function score (p < 0.001) were significantly higher for the well-controlled group compared to the poorly controlled group. Additionally, the well-controlled group showed lower levels of childhood depression, as evidenced by lower Children's Depression Inventory scores (p < 0.001).

Conclusion: Our findings provide strong evidence of the association between asthma control status and childhood depressive symptoms in pediatric asthma patients. Effective asthma management was associated with lower levels of depressive symptoms, better respiratory function, improved sleep quality, increased physical activity, and higher quality of life, highlighting the need for comprehensive care and integrated management approaches in pediatric asthma to optimize health outcomes. These findings hold significance for clinical practice, offering valuable insights into the subtle factors influencing asthma control and depressive symptoms in pediatric asthma patients.

Background: Overweight/obese adolescents show higher rates of depression. This study aims to explore the effect of aerobic exercise program management on overweight/obese adolescents with depression.

Methods: This retrospective study analyzed clinical data of overweight/obese adolescents with depression at Wuhan Mental Health Center, from June 2019 to June 2022. Propensity score matching (PSM), t-tests, and chi-square tests were applied. Observation indexes including Hamilton Anxiety Scale (HAMA), Hamilton Depression Rating Scale 17 (HAMD-17), Simplified Coping Style Questionnaire (SCSQ), body mass index (BMI), waist-hip ratio (WHR), nursing effectiveness, and Generic Quality of Life Inventory-74.

Results: A total of 229 depressed overweight/obese adolescents were divided into two groups: the control group (n = 108) receiving routine care only, and the observation group (n = 121) receiving routine care along with aerobic exercise. After 1:1 PSM (caliper 0.02), groups (each group comprised 104 patients) showed no baseline differences. No significant differences were found in HAMA, HAMD-17, SCSQ, quality of life scores, BMI, and WHR pre-exercise (p > 0.05). Post-nursing care, the observation group exhibited significantly lower HAMA (t = 3.589, p = 0.001), HAMD-17 (t = 3.554, p = 0.001), SCSQ negative scores (t = 3.584, p = 0.001), BMI (t = 3.051, p = 0.003), and waist-to-hip ratio (t = 3.379, p = 0.001), with higher SCSQ positive (t = 3.443, p = 0.001) and quality of life in material life (t = 3.385, p = 0.001), physical function (t = 3.834, p < 0.001), social function (t = 3.485, p = 0.001), psychological function (t = 3.178, p = 0.002) compared to the control group.

Conclusion: The aerobic exercise program care for overweight/obese adolescents with depression, which is advocated and has a high nursing effect, can effectively improve the anxiety and depression of patients.