Annals of General Psychiatry最新文献

Purpose: As previous research has linked smoking to suicidal behavior, it is possible that smoking may have played a role in suicidality during the COVID-19 pandemic. However, relatively little research has examined this association. To address this gap, the present study examined the relationship between smoking status and the onset of suicidal ideation in Japan during the pandemic.

Methods: Data were analyzed from 3,164 adults from the Japanese general population who participated in an online survey in early 2023. Information was collected on smoking status and incident suicidal ideation during the COVID-19 pandemic. Logistic regression was conducted to examine associations.

Results: In a fully adjusted analysis, current smoking was associated with significantly higher odds of the onset of suicidal ideation in the total sample (OR: 2.31, 95%CI: 1.37, 3.90). In a sex-stratified analysis, both former (OR: 4.49, 95%CI: 1.75, 11.50) and current smoking (OR: 6.12, 95%CI: 2.67, 14.01) were associated with the onset of suicidal ideation in men, whereas no such association was observed in women.

Conclusion: Smoking was associated with the onset of suicidal ideation among adults in Japan during the COVID-19 pandemic, with the association observed in men but not women.

Background: Major Depressive Disorder (MDD) is a prevalent mental health condition characterized by persistent feelings of sadness, loss of interest or pleasure, and a range of physical and cognitive symptoms. Despite the availability of various treatment options, many MDD patients continue to experience significant impairment in their daily lives.

Purpose: This multicenter study aimed to evaluate the therapeutic benefits of vortioxetine in routine clinical practice for patients with MDD in Saudi Arabia.

Methods: A total of 499 eligible patients participated in the study. This is a Phase IV study that included 30 psychiatric sites across Saudi Arabia. Data collection occurred at baseline and routine visits. Patients treated with vortioxetine experienced a significant reduction in depressive symptom severity, as indicated by the PHQ-9 total score, throughout the study period (p < 0.001).

Results: Significant improvements were also observed in various areas of functioning and cognitive depression symptoms, and safety. Results demonstrated a significant reduction in depressive symptoms, and sexual well-being, indicating vortioxetine as an effective treatment option for MDD in the Middle East and Africa (MEA) region.

Conclusions: These findings support the real-world effectiveness of vortioxetine as a promising treatment option for MDD patients in the MEA region, highlighting its potential to reduce depressive symptoms.

Background: The link between sleep onset time and depression is not well understood. We aimed to investigate the association of sleep onset time with depression.

Methods: Data from the 2015 to March 2020 National Health and Nutrition Examination Survey were analyzed. Sleep onset time was categorized into five intervals: [22:00-23:00), [23:00-00:00), [00:00-01:00), [01:00-20:00), and [20:00-22:00). Depression was assessed using the Patient Health Questionnaire. Multivariate logistic regression and generalized linear regression analyses were conducted to evaluate the association of sleep onset time with depression.

Results: The study sample consisted of 6991 adults (weighted mean age 45.6 years [SE, 0.5]; 49.5% female). Depression prevalence varied by sleep onset time intervals: 4.12% for [00:00-01:00), 5.94% for [01:00-20:00), 3.89% for [20:00-22:00), 1.98% for [22:00-23:00), and 3.26% for [23:00-00:00). After adjusting for sleep duration and other covariates, the odds ratios (ORs) for depressive symptoms were significantly greater at sleep onset time during [01:00-20:00) (OR, 2.39; 95% CI 1.20-4.74) and marginally higher at [20:00-22:00) (OR, 1.78; 95% CI 0.99-3.20) compared to the sleep onset time during [22:00-23:00). Higher PHQ-9 scores were associated with sleep onset time outside [22:00-23:00).

Conclusion: Sleep onset time between [22:00-23:00) was associated with the lowest odds of depression. This suggests new directions for depression research and interventions, emphasizing the importance of considering sleep onset time in mental health strategies.

Background: Childhood maltreatment is a major risk factor for mental and substance use disorders particularly among adolescents however, there's no comprehensive report of its attributable burden on anxiety, depression, and substance use disorder in Africa. This research sort to delineate the Disability-adjusted life years (DALYs) trend and age-period-cohort effects on these disorders attributable to childhood maltreatment among 10-24-year-olds in Africa.

Methods: DALY estimates and 95% uncertainty intervals for anxiety, depression, and substance use disorder attributable to childhood maltreatment among adolescents in Africa were extracted from the Global Burden of Disease Study (GBD) 2021. Trends between 1990 and 2021 were analyzed using Joinpoint regression analysis. The Age-Period-Cohort model was used to determine the effect of age, period, and cohort on these disorders.

Results: In 2021, the DALY rate for anxiety was 95.41 (37.32-185.13), 117.57 (54.31-209.16) for depression, and 3.82 (0.63-10.38) for substance use disorder per 100,000 population among adolescents in Africa. Trend analysis showed an increase in anxiety [AAPC: 0.88 (0.84-0.91)] and depressive disorders [AAPC: 0.71(0.68-0.74)]. Niger recorded the highest growth in average annual percentage change (AAPC): 3.17 [95% CI 3.08-3.27] for anxiety, Burkina Faso recorded the highest rise in AAPC: 1.96 [95% CI 1.85-2.08] for depression, and Uganda recorded the highest incline in AAPC: 0.65 [95% CI 0.59-0.72] for substance use disorder. Higher age effects were noted in all disorders, particularly in the 15-19-year group. Period effects were higher for anxiety and depressive disorders and lower for substance use disorders. A higher cohort effect was observed in all disorders during the study period.

Conclusions: Anxiety and depressive disorders due to childhood maltreatment have been on the rise for 3 decades in Africa. Given the implications of the early onset and lifetime burden of mental and substance use disorders, a comprehensive policy framework that facilitates increased access to specialists in childhood maltreatment-related mental disorder services is essential.

Background: Pet ownership is often believed to confer psychological benefits, such as reducing loneliness and providing emotional support. However, evidence on its relationship with depression is mixed, and no clear consensus currently exists. This systematic review and meta-analysis aimed to evaluate the association between pet ownership and the risk of depression.

Methods: A comprehensive systematic review and meta-analysis were performed following PRISMA guidelines. Three electronic databases (PubMed, Scopus, Web of Science) were searched for observational studies assessing the impact of pet ownership on depression. Two independent reviewers screened and extracted data, and study quality was evaluated using the Newcastle-Ottawa Scale. Random-effects models were used to compute pooled odds ratios (ORs) and 95% confidence intervals (CIs) using STATA-17.

Results: A total of 21 studies involving 159,322 participants were included. Overall, pet ownership was not associated with a significant change in depression risk compared to non-ownership (OR: 1.03; 95% CI: 0.995-1.07). However, sensitivity analyses by pet type revealed that cat ownership was associated with a modestly increased risk of depression (OR: 1.06; 95% CI: 1.02-1.09), whereas dog ownership showed no significant association (OR: 0.93; 95% CI: 0.789-1.10).

Conclusion: This study reveals a complex relationship between pet ownership and depression. Cat ownership is linked to a higher risk, while dog ownership shows mixed results. Overall, pet ownership isn't significantly associated with depression, highlighting the need for further research into its psychosocial dynamics and mental health implications.

Background: The physician-patient relationship is essential in the care of suicidal patients, yet factors shaping this relationship remain insufficiently explored. This study aimed to explore physicians' emotional reactions to suicidal patients and how both physician- and patient-related issues influence these responses.

Methods: Interviews were conducted with six physicians from the Douglas Mental Health University Institute in Montreal. A thematic analysis was performed using Hayes' structural model of countertransference as the analytical framework.

Results: Three primary emotional reactions emerged: emotional connection/avoidance, confidence/doubts, and powerlessness attributed to own limitations/to the patient. Clinicians' core needs-the need to help, need for security, and need for efficacy-were found to be pivotal in shaping these emotional responses. Similarly, patient-related factors, notably life experiences, disease, suicidality, and attitudes significantly influenced these reactions. Patterns linking physicians' emotional responses to their underlying needs and patient-related factors were analyzed, leading to the development of a conceptual framework.

Conclusions: This framework offers implications for research, clinical supervision, and medical training, fostering deeper insight into the physician-patient relationship in the context of suicidality.

Background: Mitochondrial dysfunction has been implicated in the pathogenesis of a variety of neuropsychiatric disorders, but its causal role remains unclear. Mitochondrial DNA copy number (mtDNA-CN) and methylmalonic acid (MMA) are well-recognized biomarkers of mitochondrial function, but their association with psychiatric disorders has not yet been fully assessed.

Methods: We performed two-step two-sample Mendelian randomization (MR) analyses using genome-wide association study (GWAS) data to assess causal associations between mtDNA-CN and 13 major neuropsychiatric disorders. In addition, we conducted a cross-sectional analysis using National Health and Nutrition Examination Survey (NHANES) data 2011-2014 to examine the association between serum MMA levels and cognitive impairment and depressive symptoms to further validate the correctness and robustness of the results of the MR analysis.

Results: MR analysis showed a significant negative causal effect of mtDNA-CN on bipolar disorder, Alzheimer's disease, dementia, depressive symptoms, and autism spectrum disorders (OR ranged from 0.15 to 0.84, all p < 0.05). Reverse MR analysis showed that only depressive symptoms had a significant causal effect on reducing mtDNA-CN. NHANES analysis further showed that higher MMA levels were significantly associated with an increased risk of cognitive impairment (OR = 1.56, p = 0.036) and depression (OR = 1.53, p = 0.020), suggesting that mitochondrial dysfunction and neuropsychiatric disorders have a close association.

Conclusion: The mitochondrial function biomarkers mtDNA-CN and MMA are expected to be potential therapeutic targets for depression and cognitive dysfunction, emphasizing the need for mitochondrial function monitoring and interventions in future therapies targeting neuropsychiatric disorders.

Background: Non-suicidal self-injury (NSSI) is a common behavioral problem among children and adolescents. Previous studies of NSSI have been mostly group-based and lacked specific characterization of individuals with NSSI.

Methods: Using convenience sampling, we surveyed all students from three junior high schools in a county in China, totaling 2,376 participants (mean age 13.66, SD 0.98). Assessments included NSSI, anxiety, depression, personality traits, and family environment. Based on the network template perturbation approach, we employed three steps-constructing the reference network, constructing the perturbed network, and computing the individual differential psychopathology network (IDPN). The IDPN was then constructed from questionnaire scores to capture the degree to which abnormal individuals deviate from the normative level. K-means clustering was then applied to explore the internal heterogeneity of NSSI.

Results: Among 2,376 students, 881 (37.1%) exhibited NSSI. Following IDPN construction, we selected 8 characteristics for clustering analysis based on significant changes in at least 2% of the samples. The elbow method indicated 2 clusters. Fisher discriminant analysis showed a classification accuracy of 95.8%, reflecting a good clustering effect. Severity of NSSI in Group 1 was lower than in Group 2, with scores for 7 out of 8 characteristics also lower in Group 1, except for "Control-Organization." NSSI was associated with personality traits, depression, and family environment, with stronger connections between individual features linked to higher NSSI severity.

Conclusion: We introduced the concept of IDPN in psychometrics, which can reveal relationships among individual characteristics and identify distinct patient subgroups. Further research is needed to confirm its reproducibility and generalizability.

Objective: This study aimed to explore the efficacy and safety of Bifidobacterium combined with high-frequency repetitive transcranial magnetic stimulation (rTMS) in treating depression in adolescents.

Methods: A total of 100 patients were selected and divided into an experimental group (n = 50) and a control group (n = 50) using a random number table. Patients in the experimental group were treated with Bifidobacterium and high-frequency rTMS, and those in the control group were treated with oral escitalopram oxalate. After 8 weeks of treatment, the Hamilton Rating Scale for Depression (HAMD-24) score, serum inflammatory factors, neuroendocrine indicators and microRNAs were determined in both groups. The single-blind principle was strictly followed throughout the study.

Results: The HAMD-24 score after treatment significantly decreased in the experimental group compared with the control group, with a statistically significant difference (p < 0.05). The levels of serum tumour necrosis factor-α, interleukin (IL)-1β and IL-6 also decreased significantly in the experimental group compared with the control group (p < 0.05). Additionally, the elevated levels of dopamine, serotonin and cortisol, including dopamine, 5-hydroxytryptamine and cortisol, was more pronounced in the experimental group than in the control group. The serum levels of miR-16 and miR-195 also showed statistically significant differences (p < 0.05).

Conclusion: Bifidobacterium combined with high-frequency rTMS is effective in the treatment of depression in adolescents with a favourable safety profile, providing references for the clinical treatment of this disease.

Clinical trial number: ISRCTN16752763 ( https://doi.org/10.1186/ISRCTN16752763 ), Date: 19/03/2025.

Background: Theoretical hypotheses suggest differing oxidative stress levels in mood disorders. We evaluated eight oxidative stress-related biochemical markers for further verification in first-onset patients with bipolar disorder (BD) or major depressive disorder (MDD).

Methods: We extracted 224 first-onset patients (BD = 93 and MDD = 131) from the overall sample database of 4647 candidates. And we analyzed eight parameters: direct bilirubin (DBIL), indirect bilirubin (IBIL), uric acid (UA), lactate dehydrogenase (LDH), thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), prealbumin, and progesterone.The above parameters enter the hierarchical multiple linear regression model for analysis.

Results: When compared to MDD, the BD group showed decreased prealbumin and elevated UA, LDH, and FT3 in males while decreased prealbumin and DBIL and elevated IDBIL, LDH, FT3 and progesterone in females (p's < 0.05). The model effectively differentiated between BD and MDD, achieving AUCs of 0.894 for men and 0.897 for women.

Conclusion: This result elucidates the validity of these biomarkers for identifying first-episode patients with BD or MDD. The discrimination was satisfactory, with good diagnostic accuracy for both gender subgroups.