Annals of General Psychiatry最新文献

Objectives: Proinflammatory cytokines are linked to cognitive deficits in bipolar disorder (BD). The programmed cell death (PD) pathway, involved in immune regulation, may impact mood disorders and dementia. Older age BD (OABD) patients face a heightened risk of cognitive decline, yet studies exploring the underlying mechanisms in this population are scarce. Aim of this study is to investigate proinflammatory cytokines and the PD pathway in OABD, for their correlation with clinical features and neuroaxonal integrity, and the impact on cognitive domains.

Methods: Eighty-seven euthymic OABD patients were assessed using the Brief Assessment of Cognition in Affective Disorders. We measured CRP, IL-6, TNF-α, TNF-R1, TNF-R2, PD-1, and PD-L1. Neurofilament light chain (NfL) was used to gauge neuroaxonal integrity. Associations between cytokines, PD-1/PD-L1, and cognition were examined using linear regression models.

Results: The average age of the OABD patients was 59.64 with a mean illness duration of 27.19 years. NfL levels positively correlated with TNF-R2 levels. Regression analysis revealed a negative association between TNF-R1 and motor speed and verbal fluency, while TNF-R2 showed positive associations with these cognitive domains. PD-1 was negatively associated with composite score, especially in motor speed and working memory, while PD-L1 was positively associated with executive function.

Conclusion: This is the first study to simultaneously examine the proinflammatory system and the PD-1/PD-L1 pathway in a clinical OABD sample, with findings suggesting that both systems impact cognitive function in OABD patients. Further research is needed to explore the neuroinflammatory mechanisms underlying BD's neurodegenerative course.

Background: Somatic symptoms are physical symptoms that often arise in response to emotional distress and can significantly impact well-being. Understanding the prevalence and interplay of these symptoms with anxiety and depression is crucial for understanding adolescent health outcomes in Singapore. This study aimed to determine the prevalence of somatic symptoms among adolescents in Singapore and examine their associations with demographic characteristics, life stressors, anxiety, and depression.

Methods: We conducted a cross-sectional online survey with 601 Singaporean adolescents aged 12 to 19, using the Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptoms Scales (PHQ-SADS) to assess somatic symptoms, anxiety, and depression levels. Demographic information and experiences with stressful life events were also collected. Both descriptive and regression analyses were used to understand the relationships between participants' sociodemographic factors, mental health symptoms, and the presence of somatic symptoms.

Results: 32.3% of the adolescents reported clinically significant levels of somatic symptoms, with a higher prevalence observed among those who were females and older. While no significant associations were found between somatic symptoms and demographic factors, adolescents with anxiety or depressive symptoms presented significantly increased odds of reporting somatic symptoms. Specifically, the odds of reporting somatic symptoms were 2.91 times greater for those with anxiety (95%CI: 1.55-5.45, p < 0.001) and 6.54 times greater for those with depression (95%CI: 3.75-11.6, p < 0.001) than for those without these mental health concerns. Furthermore, those with somatic symptoms reported a greater number of stressful life events, with academic pressure emerging as the most prominent stressor.

Conclusions: This study highlights the prevalence of somatic symptoms among adolescents in Singapore, emphasising the interconnectedness of mental and physical health during this developmental stage. The strong associations between somatic symptoms, anxiety, depression, and life stressors underscore the need for a holistic approach to adolescent healthcare. Early identification and intervention strategies should focus on addressing mental health concerns, building resilience against stressors, and promoting healthy coping mechanisms to mitigate the burden of somatic symptoms and foster overall well-being in Singaporean adolescents.

Background: Misophonia is a condition characterized by a reduced tolerance to certain sounds and strong emotional, physiological, and behavioral responses. Existing research on the relationship between misophonia and psychopathologies in children remains limited. To our knowledge, the relationship between Cognitive Disengagement Syndrome (CDS), formerly known as sluggish cognitive tempo, and attention deficit hyperactivity disorder (ADHD) and misophonia has not been investigated to date. In this study, we examined the relationship between misophonia and ADHD and CDS symptoms and possible mediating factors.

Method: The study included 53 adolescents diagnosed with ADHD and a control group of 50 adolescents without ADHD. All participants underwent a semi-structured clinical interview using the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, Turkish version (K-SADS-PL). Misophonia symptoms were assessed with the Amsterdam Misophonia Scale-Revised (AMISOS-R). In contrast, CDS symptoms were measured using the Sluggish Cognitive Tempo Self-Report Scale (SCT-SR). ADHD symptom severity was evaluated using the Turgay DSM-IV-Based Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S), which the participants' parents completed.

Results: AMISOS-R scores were higher in adolescents with ADHD compared to the control group. The AMISOS-R revealed significant correlations with ADHD-hyperactivity/impulsivity (r = 0.291), ADHD-inattention (r = 0.513), and SCT-SR (r = 0.661) symptoms. As a result of regression analysis, ADHD-inattention severity (β = 0.745, p < 0.001) emerged as the variable that was significant with adolescent misophonia severity, independently of other variables.The mediation test using the bootstrap method showed that the indirect coefficient for SCT-SR in the relationship between T-DSM-IV-S Inattention and AMISOS-R was significant, and consistent with partial mediation.

Conclusion: Our findings indicate that symptoms of misophonia are significantly associated with ADHD and CDS symptoms, and the importance of recognizing the comorbidity of misophonia in ADHD patients. Notably, although ADHD-inattention was associated considerably with misophonia, this association was mediated by CDS severity. Therefore, when assessing individuals with symptoms of misophonia, it is important to screen specifically for ADHD-inattention and CDS symptoms as well. Further research is needed to explore these relationships in more detail and to expand our knowledge of the underlying mechanisms.

Background: Mental pain is increasingly recognized in clinical settings as a significant transdiagnostic construct that can exacerbate the condition of individuals suffering from it. It is also widely acknowledged as one of the strongest indicators of suicide risk. This study focuses on the Italian validation of the Orbach and Mikulincer Mental Pain Scale-8 (OMMP-8).

Methods: A total of 1,546 participants responded to an online cross-sectional survey assessing sociodemographic and clinically relevant variables, mental pain and other mental health variables (i.e., tolerance for mental pain, current physical pain, anxiety and depression, and wellbeing).

Results: The Italian version of the OMMP-8 maintained the same factorial structure as the original instrument and demonstrated excellent convergent validity. Moreover, the instrument showed strong criterion validity, effectively distinguishing between individuals receiving mental health treatment, those with recent suicidal ideation, and those with a history of suicide attempts. ROC curve analyses indicated good discrimination for recent suicidal ideation (AUC = 0.81) and acceptable discrimination for suicide attempt history (AUC = 0.71), with an optimal cut-off score of ≥ 21.5. In addition, the Italian OMMP-8 demonstrated incremental validity, predicting suicidal ideation and past suicide attempts after controlling for depressive symptoms. It also exhibited scale measurement invariance for gender, age, current mental health treatment, and current suicidal ideation while residual invariance was established for gender, age, and treatment status.

Conclusion: The Italian OMMP-8 is an agile, valid, and reliable instrument for assessing mental pain and shows promise in identifying individuals at risk of suicide.

Background: Somatic symptoms are common in adolescent major depressive disorder (MDD) and related to severity of depression and clinical outcomes. However, the neurological mechanism of somatic symptoms in adolescent MDD remains unknown. In this study, we aimed to explore the functional alterations of intrinsic brain local connectivity in adolescent MDD with somatic symptoms based on static and dynamic reginal homogeneity (ReHo).

Methods: This study included 50 first-episode, drug naïve adolescent MDD patients and 34 healthy controls (HCs) matched for age, gender and years of education. Patients were categorized into somatic depression (SD) group (n = 21) and non-somatic depression (NSD) group (n = 29) based on the presence of somatic symptoms or not. All participants underwent resting-state functional magnetic resonance imaging (rs-fMRI), and static and dynamic ReHo were calculated and compared among SD, NSD and HC groups. Correlation analysis was performed to evaluate the relationship between altered ReHo values and severity of clinical symptoms.

Results: Adolescent MDD patients with somatic symptoms showed higher total scores of the 17-items Hamilton Depression Scale (HAMD-17). Moreover, increased static ReHo in left inferior parietal gyrus (IPG), left superior parietal gyrus (SPG) and left triangular part of inferior frontal gyrus (IFGtriang) were observed in SD group compared with NSD group. The SD group also exhibited decreased dynamic ReHo in bilateral IPG, bilateral SPG, and left IFGtriang. Moreover, there were significant correlations between static and dynamic ReHo values in these abnormal brain regions and the weight factor scores of HAMD-17.

Conclusions: Our findings suggested that there may be abnormal patterns of functional local connectivity in SPG, IPG and IFGtriang in adolescent MDD patients with somatic symptoms, enriching the knowledge of neurological mechanism concerning somatic symptoms in adolescent MDD.

Background: The causal relationship between keloid and mental disorders remains unclear. The aim of this study was to investigate whether keloid was causally associated with the risk of bipolar disorder (BD), anxiety, schizophrenia (SCZ), major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) using a bidirectional Mendelian randomization (MR) analysis.

Methods: The large available genome-wide association study (GWAS) dataset of keloid, BD, anxiety, SCZ, MDD and PTSD was used for summary statistics. The bidirectional MR analyses were performed using a variety of methods of analysis including inverse variance weighting, MR-Egger regression, weighted median, simple modal and weighted modal methods. Sensitivity analyses were conducted using Cochran's Q to estimate heterogeneity, and the MR-Egger method was used to estimate horizontal pleiotropy.

Results: MR analysis showed that keloid susceptibility was associated with an increased risk of BD (OR = 1.027, 95% CI: 1.005-1.049, p = 0.015) and SCZ (OR = 1.023 (95% CI: 1.006-1.040, p = 0.006). We also observed a negative association between keloid and PTSD (OR = 0.903, 95% CI: [0.835-0.977], p = 0.011). There was no evidence for a causal relationship between keloid and anxiety (OR = 0.982, 95% CI: 0.961-1.004, p = 0.110) and MDD (OR = 0.997, 95% CI: 0.987-1.006, p = 0.476). Reverse MR analysis revealed that there was no causal relationship between keloid and the mental disorders.

Conclusion: This study provides evidence that there is a link between BD, SCZ, PTSD and keloid. However, there was no causal relationship between anxiety, MDD and keloid. This study may provide important clues and references for the study of keloid and mental disorders. We urge that the mental conditions of keloid patients should be taken into account in clinical practice and that necessary psychological support should be provided.

Objective: Major Depressive Disorder (MDD) is a significant mental health problem, frequently comorbid with both physical and psychiatric disorders. The association between MDD and obesity is not fully understood. Eating motivations (EMs), which relate to why and how individuals choose to eat, may be associated with disorders like obesity and MDD. Hopelessness and suicidal ideation are common symptoms of MDD. This study aimed to evaluate the relationship between EMs, depression, body mass index (BMI), hopelessness, and suicidal ideation in normal-weight and obese MDD groups compared to healthy controls.

Method: The study included 50 patients with MDD and normal weight (BMI 18.5-24.9), 50 patients with MDD and obesity (BMI > 30), and 50 healthy control participants (BMI 18.5-24.9). The majority of participants were women (74% in obese MDD, 70% in normal-weight MDD, 56% in the control group). The age of the groups was similar for the normal-weight MDD and control groups, but the obese MDD group was older (control: 32.72 ± 10.07, normal-weight MDD 33.42 ± 10.24, obese MDD 39.52 ± 10.67, p = 0.002). Regarding BMI, it was as follows: control: 21.61 ± 1.92, normal-weight MDD 23.54 ± 3.60, and obese MDD 35.30 ± 5.07. Sociodemographic data form, Beck Depression Inventory, Beck Hopelessness Inventory, Suicide Ideation Scale and Eating Motivation Questionnaire were administered.

Results: No significant differences were found between the MDD groups in terms of Beck Depression Inventory (BDI), Beck Hopelessness Inventory (BHI), and Suicidal Ideation Scale (SIS) scores. Significant differences were observed among all groups in most subtypes of EMs. In the obese MDD group, habits, traditional eating, price, visual appeal, and affect regulation were correlated with suicide attempts. Only traditional eating remained associated with suicide attempts, where a one-unit increase in the traditional eating score explained a 0.724-unit increase in suicide attempts. Additionally, emotion regulation was a significant predictor of suicidal ideation in the obese MDD group, where a one-unit increase in emotion regulation explained a 0.885-unit increase in suicidal ideation.

Conclusions: The differentiation between suicidal ideation and EMs in obese and normal-weight MDD groups is crucial. The observed differences in EMs among the three groups with similar sociocultural characteristics are noteworthy. Clinicians should assess eating motivations as part of suicide risk evaluations in patients with comorbid MDD and obesity. Longitudinal studies are needed to clarify causal relationships between these variables.