Asian journal of psychiatry最新文献

Aim

This retrospective study aimed to evaluate the long-term effectiveness of switching to clozapine in the management of tardive syndromes (TS).

Methodology

The treatment records of patients who had TS at the time of starting clozapine, were reviewed and demographic and clinical data was extracted on a predesigned performa.

Results

About three-fourth (74.2 %) of the study subjects had tardive dystonias and two-third (69.7 %) had tardive dyskinesia at the time of starting clozapine. About half (48.5 %) of the patients had both tardive dystonia and dyskinesia. A small proportion (13.6 %) also had tardive akathisia at the time of starting clozapine. About three-fourth (72.2 %) of the patients had >50 % reduction, and about two-third (66.6 %) of the patients had >75 % reduction and nearly half (54.5 %) of the patients had complete resolution of dyskinesia at the last follow-up. Similar trends were seen in reduction in dystonia, i.e., >50 % reduction in 74.3 %, >75 % reduction in 62.2 % and complete resolution was seen in 56.1 %.

Conclusions

The present study suggest that clozapine is useful in the management of drug induced tardive dyskinesia and tardive dystonia.

Although large-scale genome-wide association studies (GWASs) have revealed the genetic architecture of schizophrenia, these studies have mainly focused on populations of European ancestry. This study aimed to identify common genetic variants associated with schizophrenia in the Korean population and evaluate the performance of polygenic risk scores (PRSs) derived from large-scale GWASs across ancestries. In the Korean psychiatric GWAS project (KPGP), seven academic institutes and their affiliated hospitals across South Korea recruited a cohort of 1670 patients with DSM-IV-defined schizophrenia and 2271 healthy controls. A total of 6690,822 SNPs were tested for association with schizophrenia. We identified one previously unreported genome-wide significant locus rs2423464 (P = 2.83 × 10⁻¹¹; odds ratio = 1.65; 95 % confidence interval = 1.43–1.91, minor allele frequency = 0.126). This variant was also associated with increased lysosomal-associated membrane protein family member 5 (LAMP5) gene expression. The PRS derived from the meta-analysis results of East Asian and European GWASs explained a larger proportion of the phenotypic variance in the Korean schizophrenia sample than the PRS of an East Asian or European GWAS. (R² = 0.073 for meta-analysis; 0.028 for East Asian GWAS; 0.037 for European GWAS). GWASs involving diverse ethnic groups will expand our understanding of the genetic architecture of schizophrenia.

The integration of artificial intelligence (AI) into the diagnosis and treatment of autism spectrum disorder (ASD) represents a promising frontier in healthcare. This review explores the current landscape and future prospects of AI technologies in ASD diagnostics and interventions. AI enables early detection and personalized assessment of ASD through the analysis of diverse data sources such as behavioural patterns, neuroimaging, genetics, and electronic health records. Machine learning algorithms exhibit high accuracy in distinguishing ASD from neurotypical development and other developmental disorders, facilitating timely interventions. Furthermore, AI-driven therapeutic interventions, including augmentative communication systems, virtual reality-based training, and robot-assisted therapies, show potential in improving social interactions and communication skills in individuals with ASD. Despite challenges such as data privacy and interpretability, the future of AI in ASD holds promise for refining diagnostic accuracy, deploying telehealth platforms, and tailoring treatment plans. By harnessing AI, clinicians can enhance ASD care delivery, empower patients, and advance our understanding of this complex condition.

Background

Although vortioxetine demonstrates superior efficacy relative to placebo, there is still a lack of robust evidence to determine whether it offers advantages over commonly prescribed antidepressants for treating major depressive disorder (MDD). Thus, we aimed to perform a systematic review and meta-analysis comparing vortioxetine vs reuptake inhibitors in adults with MDD, analyzing two classes separately: (i) vortioxetine vs SSRIs and (ii) vortioxetine vs SNRIs.

Methods

We searched MEDLINE, Embase, and Cochrane Library databases for randomized controlled trials comparing vortioxetine with SSRIs or SNRIs in adults with a primary diagnosis of MDD following standardized diagnostic criteria. Independent examiners conducted the literature search, study selection, data extraction, and risk of bias assessment. Data were pooled in random-effects analyses. Statistical significance was considered at p<0.05.

Results

We included 6 trials (n=478) in the vortioxetine vs SSRIs analysis and 11 (n=4230) in the vortioxetine vs SNRIs analysis. There were no significant differences between vortioxetine and SSRIs/SNRIs in the probability of response, remission, overall dropouts, and dropout due to lack of efficacy. Vortioxetine provided a significantly lower risk of dropout due to adverse events compared with SNRIs, while not significant compared with SSRIs. Vortioxetine did not differ significantly from SNRIs regarding variation in MADRS score post-treatment. In general, vortioxetine exhibited a statistically lower risk of individual adverse events compared with SNRIs, while not significant compared with SSRIs.

Conclusions

Our study reveals that vortioxetine is as effective as SSRIs and SNRIs for treating MDD, with safety equivalent to SSRIs and superior to SNRIs.

Maternal mental health is a global priority. Like other low-and middle-income countries, maternal mental health issues are highly prevalent in Sri Lanka. While the country claims to have achieved a satisfactory level of maternal health care indicators in the Southeast Asian region, maternal mental health care remains ignored. The COVID-19 pandemic followed by the economic crisis of 2022 has worsened the situation in the country by increasing the prevalence of maternal mental health issues and limiting the availability of and capacity of the country to allocate resources for the healthcare provision for maternal mental health issues. Integrating task-shifted, non-specialist based, mental healthcare into the existing maternal healthcare programme is considered a cost-effective approach in addressing maternal mental health. In this article, we discuss the opportunities and challenges of employing task shifting to address maternal mental health issues in Sri Lanka.

Cultural perspectives on marijuana consumption have undergone substantial reforms in recent years, and the decriminalization and legalization of cannabis are a matter of debate now. The conditions of determining factors are not the same among societies; therefore, each society should decide independently. Herein, the considerations that Iran should contemplate before legalizing cannabis were addressed. Global trends, social status, influence on the judiciary, costs, health effects, quality control, shifting substance use patterns, societal detachment, and changes in prevalence were the discussed determinant factors. Now that religious, cultural, and legal status has suppressed the increase in prevalence, legalization of recreational use that leads to a significant increase in consumption is not advisable. However, the legalization and production of medical cannabis should be on the agenda, as none of the items that hinder the legalization of recreational cannabis do not apply to medical cannabis. Research should continue to reduce uncertainties, especially by combining big data from sale systems of areas where recreational cannabis use has been legalized with big data sources like social media.

Objectives

South Korea operates a complete enumeration surveillance of coronavirus disease 2019 (COVID-19). Online mental health survey links were distributed to all COVID-19 confirmed patients within three days of confirmation of infection. This study evaluates the trend of depressive symptoms, anxiety symptoms, post-traumatic stress symptoms, somatic symptoms, and suicidal ideation of COVID-19 confirmed cases across the pandemic from January 2020 to July 2022.

Methods

A total of 99,055 responses were analyzed. Validated questionnaires were used to assess depressive symptoms (Patient Health Questionnaire-9), anxiety symptoms (Generalized Anxiety Disorder-7), post-traumatic stress symptoms (Primary Care Post Traumatic Stress Disorder screen), somatic symptoms (Patient Health Questionnaire-15), and suicidal ideation (P4 suicidality screener). Log-binomial regression was used to estimate prevalence ratio across 11 quarters (Q) of the year (2020Q1 to 2022Q3). Stratified analysis was conducted by sex to compare risk between males and females when adjusted prevalence was high.

Results

Compared to 2022Q1 (January-March), all symptoms had their highest prevalence ratio during 2020Q1 to 2020Q3 (January-September). The difference in adjusted symptom prevalence between males and females was nonsignificant during high-risk periods.

Conclusions

Adverse mental health symptoms were most prevalent during the early pandemic, with a nonsignificant difference in prevalence observed between males and females. Greater attention should be given to individuals who experienced COVID-19 infection during the early stages of the pandemic.