Asian journal of psychiatry最新文献

Background

Schizophrenia remains a major public health challenge, and designing efforts to manage it requires understanding its prevalence over time at different geographic scales and population groups.

Methods

Drawing on data from the Global Burden of Disease study 2019, annual percentage change of schizophrenia was assessed across different age, period and cohort groups at different geographic scales from 1990 to 2019. We examined associations of prevalence with the sociodemographic index.

Results

Global prevalence of schizophrenia in 2019 was 23.60 million (95 % uncertainty interval: 20.23–27.15), with China, India, the USA and Indonesia accounting for 50.72 % of it. Global prevalence increased slightly from 1990 to 2019, with an annual percentage change of 0.03 % (95 % confidence interval 0.01–0.05). Regions with intermediate sociodemographic index accounted for greater proportion of prevalence increasing than regions with high index. Prevalence decreased among those born after 1979 in regions with intermediate sociodemographic index, whereas it consistently improved among all birth cohorts in regions with low index. Regardless of sociodemographic index, prevalence was highest among individuals 30–59 years old than younger or older groups.

Conclusions

Prevalence of schizophrenia has shown small increases globally over the last three decades. The burden of disease is heavier in relatively less affluent regions, and it disproportionately affects individuals 30–59 years in all regions. Meanwhile, for regions with lower sociodemographic indices, the recent increasing burden among birth cohorts is more pronounced. These findings may help guide futural design of measures to manage or prevent schizophrenia in communities at higher risk.

Background

The number of patients with Alzheimer’s disease (AD) has increased dramatically in Asia.

Objective

To update the demographic characteristics of patients with AD and their informants in eight Asian countries and compare them from 12 years prior.

Methods

The A1–A3 components of the Uniform Dataset (UDS), version 3.0, were administered in Taiwan, Beijing, Hong Kong, Korea, Japan, Philippines, Thailand, and Indonesia. Data were compared with patients with AD in the first registration using the UDS version 1.0 from 2010–2014 in the same regions.

Results

A total of 1885 patients with AD and their informants were recruited from 2022 to 2024 and were compared with 2042 patients recruited a decade prior. Each country had its own unique characteristics that changed between both eras. The mean age of the patients and informants was 79.8±8.2 years and 56.5±12.1 years, respectively. Compared with the first registration, the patients were older (79.8 vs 79.0, p=0.002) and had worse global function (mean CDR-SB scores 6.1 vs 5.8, p<0.001); more informants were children (56 % vs. 48 %, p<0.001), and their frequency of in-person visits increased significantly if not living together. A total of 11 %, 4.5 %, 11 %, and 0.4 % of the patients had a reported history of cognitive impairment in their mothers, fathers, siblings, and children, respectively; all percentages, except children, increased significantly over the past decade.

Conclusion

The present study reports the heterogeneous characteristics of patients with AD and their informants in Asian countries, and the distinct changes in the past decade. The differences in dementia evaluation and care between developing and developed countries warrant further investigation.

The purpose of this article is to provide an additional point of view containing discussion, implications, and recommendations for intervention to autistic persons who have suicidal ideation and behavior. Therefore, the author hopes that this article can complement reports on several previous studies that have had an extraordinary impact.

Adolescents with major depressive disorder (MDD) experience significant difficulties in emotion regulation. This study aimed to explore emotion regulation in adolescents with depression using an emotion regulation paradigm combined with event-related potentials (ERP) while investigating the relationship between maternal emotion regulation and adolescent depressive symptoms through a mediation model. Overall, 38 healthy controls (HC) and 57 adolescents with depression (MDD) rated the pictures they saw according to aversive reappraisal (reappraisal of an aversive picture or down-regulate aversive emotions), aversive watch, and neutral conditions. Adolescents with depression gave more negative ratings to aversive images, and the emotional regulation success index (ERSI) of adolescents with depression was lower than that of healthy individuals. ERP data revealed an elevation in late positive potential (LPP) amplitude during the aversive reappraisal and aversive watch conditions compared with that in the neutral condition in the MDD group. Compared with the HC group, adolescents with depression showed larger LPP amplitudes under aversive watch conditions. The aversive reappraisal condition evoked a larger LPP than that in the other conditions in the HC group in the late time windows. The ΔLPP (separating the variability in the ERP wave associated with emotion regulation) was larger in the HC group than in the MDD group. Mediation analysis revealed that maternal emotion regulation influenced adolescent depression levels through its effect on the adolescent’s emotion regulation. These findings provide important insights into the emotion regulation process in adolescents with depression and offer suggestions for clinical interventions.

Background

Despite the widespread use of attention-deficit hyperactivity disorder (ADHD) medications and their known sympathomimetic effects on the cardiovascular system, cardiovascular risk assessment of these medications using comprehensive global data is limited. This study investigated the association between individual ADHD medications and cardiovascular disease (CVD) using global pharmacovigilance data.

Methods

Reports from the World Health Organization international pharmacovigilance database were utilized (1967–2023; total reports, n=131,255,418). Reporting odds ratios (ROR), and information components (IC) were calculated to evaluate the association between each medication and specific CVDs.

Results

We identified 13,344 CVD cases related to ADHD medications out of 146,489 cases of all reports on ADHD medications. Cumulative reports on ADHD medications have shown a steady increase, notably in adults since 2010. ADHD medications were associated with a higher risk of CVD overall (ROR [95 % CI], 1.60 [1.58–1.63]; IC [IC_0.25], 0.63 [0.60]), with a higher association observed in females than in males. Among specific CVDs, all drugs were associated with an increased risk of torsade de pointes/QT prolongation, cardiomyopathy, and myocardial infarction. Conversely, heart failure, stroke, and cardiac death/shock were exclusively associated with amphetamines. Lisdexamfetamine showed a weaker association with all CVDs compared to amphetamines, and methylphenidate exhibited the lowest overall association with CVD. Atomoxetine had the second-highest association with torsade de pointes/QT prolongation.

Conclusions

The associations between CVDs and ADHD medications vary, with amphetamines posing a higher risk, while lisdexamfetamine and methylphenidate exhibit better safety profiles.

Background

Major psychiatric illnesses often cluster in families, and their impact on affected and unaffected members within families may reflect the consequence of both genetic and social liability.

Methods

Data was derived from 202 families with multiple affected individuals. Affected individuals (N = 259) had a diagnosis of schizophrenia, bipolar disorder, obsessive-compulsive disorder or substance use disorder. For comparison, we used the unaffected siblings from the same families (N = 229) and a matched random subset of healthy control (HC) data (N = 229) from India’s National Mental Health Survey, 2016 (NMHS). We compared the three groups' educational attainment, functional marital status, and occupational status.

Results

The highest educational attainment was significantly different between the groups. The affected and unaffected siblings had poorer educational attainment compared to HC. Similarly, the affected and unaffected siblings more often remained single, in contrast to HC. Moreover, employment rates were significantly higher in the unaffected siblings, especially female siblings. Overall, females had spent fewer years at school, were primarily married, and were majority homemakers across the three groups compared to males.

Discussion

Affected and unaffected siblings had lower education and marriage rates than HC. The unaffected siblings were more likely to be employed than HC. Whether the poor educational attainment and lower marriage rates in unaffected siblings is a biological marker of shared endophenotype or the effect of the social burden of having an affected family member requires further systematic evaluation.

There is an ongoing debate regarding whether ICD-11 complex PTSD and DSM-5 borderline personality disorder (BPD) are the same syndrome. Little is known about the extent to which these two conditions overlap and whether they exhibit distinct clinical correlates in Asian cultures. This study examined the co-occurrence of ICD-11 complex PTSD and DSM-5 BPD in a sample of treatment seekers in Hong Kong (N = 220). Participants completed validated self-report measures which assessed if they met the respective diagnostic criteria. In this sample, 30.9 % met the ICD-11 criteria for complex PTSD only, 10.0 % met the DSM-5 criteria for BPD only, and 28.2 % met the criteria for both conditions. Complex PTSD symptoms were most strongly associated with depressive symptoms (β =.347, p <.001) and trauma-related maladaptive beliefs (β =.337, p <.001), while BPD symptoms were most strongly associated with dissociative symptoms (β =.281, p <.001). This study is the first to show that ICD-11 complex PTSD and DSM-5 BPD commonly co-occurred but were not the same construct in the Asian context, and their symptoms were associated with different sets of demographic and clinical factors. Future editions of DSM and ICD should not merge the two conditions into a single diagnosis.

Background

Electroconvulsive therapy (ECT) is considered to be a treatment of choice in patients with catatonia, who do not respond to lorazepam, irrespective of the underlying aetiology. Although, significant data is available for successful use of ECT in patients with catatonia secondary to affective and psychotic disorders, little information is available for use of ECT in organic catatonia.

Aim

To assess demographic and clinical profile of patients with organic catatonia receiving ECT.

Methodology

Using a retrospective study design, ECT register of the department was reviewed for the period of 2019–2023 to identify the patients with organic catatonia, who received ECT. The treatment records of these patients were reviewed to extract the demographic and clinical profile.

Results

During the study period, out of the 926 patients who received ECT, 12 (1.3 %) patients diagnosed with organic catatonia received ECT. The mean age of study sample was 41.67 (SD- 20.68) years and mean number of ECTs given in a course of ECT were 8 (SD- 4.3). In majority of the patients, ECT was considered after the failure of lorazepam challenge test. Majority (75 %) of the patients showed good response to ECT and only 16.67 % of the patients experienced complications during the course of ECT.

Conclusion

ECT is an effective and well-tolerated treatment for organic catatonia.